Posted on: October 9, 2021
This position will cover Region 5 which includes Fayetteville
and the Southeastern portion of the state
Your career starts now. We’re looking for the next generation of
health care leaders.
At AmeriHealth Caritas, we’re passionate about helping people get
care, stay well and build healthy communities. As one of the
nation's leaders in health care solutions, we offer our associates
the opportunity to impact the lives of millions of people through
our national footprint of products, services and award-winning
programs. AmeriHealth Caritas is seeking talented, passionate
individuals to join our team. Together we can build healthier
communities. If you want to make a difference, we’d like to hear
Headquartered in Philadelphia, AmeriHealth Caritas is a
mission-driven organization with more than 30 years of experience.
We deliver comprehensive, outcomes-driven care to those who need it
most. We offer integrated managed care products, pharmaceutical
benefit management and specialty pharmacy services, behavioral
health services, and other administrative services. Discover more
about us at www.amerihealthcaritas.com.
This role is eligible for a $5,000 sign-on
The Care Manager (RN) assists members appropriate for care
management and care coordination services in achieving their
optimal level of health through self-management. The Care
Manager (RN/)is responsible for engaging the member, member care
giver and providers to assess plan and establish individual member
goals. Will facilitate and coordinate care for the members while
assuring quality and use of cost-effective resources. The
position will function as a single point of contact and be an
advocate for members in the care management program. In addition
the Care Manager will oversee these same care management activities
within assigned AMH Tier III/CIN practices to ensure the AMH Tier
III/CIN delivers high quality care management services in
accordance with Plan, NCQA, Federal/State standards and
Assess members through face to face encounter or by telephone
to determine care coordination and care management needs for all
Completes comprehensive person centered assessment inclusive of
physical health history, mental health history, social determinants
of health and supportive needs.
Coordinates physical, behavioral health and social
Provides medication management, including regular medication
reconciliation and support of medication adherence;
Identifies problems/barriers for care coordination and
appropriate care management interventions.
Creates a plan of care to assist members in reducing/resolving
problems and or barriers so that members may achieve their optimal
level of health.
Identifies goals and assigns priority with associated time
frames for completion. Shares goals with the member and
Identifies and implements the appropriate level of intervention
based upon the member’s needs and clinical progress.
Schedules follow up calls as necessary, makes appropriate
referrals. Implements actions to address member issues.
Documents progress towards meeting goals and resolving
Coordinates care and services with the Care Coordinator,
Community Health Navigator, and member, member care giver as
appropriate, PCP, Specialist, and Facility/Vendor Providers.
Provides transitional care management. Meets regularly with
AMH/CIN regarding Plan identified members for care management,
assist with reducing/resolving problems and or barriers so that the
AMH/CIN may provide members with high quality care management
Participate in regularly scheduled meetings with the AMH/CIN
including but not limited to JOC meetings as needed.
3 years professional practice experience.
Valid driver’s license with car insurance. Active state RN
Valid driver’s license with car insurance.
3 to 5 years of Case/Care Management preferred.
Must reside in NC and in or near region 5 (Southeast portion of
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