Job Description

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nations 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 would like to hear you.

Headquartered in Newtown Square, 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.

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Role Overview

The Care Manager II (RN) assists members appropriate for care coordination and case management services in achieving their optimal level of health. The Care Manager II (RN is responsible for engaging the member 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 coordination program. 

Responsibilities

• Assess members to determine care coordination and case management needs for all referred members
• Completes comprehensive assessment of environmental, Psycho-social and support needs
• 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 both short and long term goals and associated time frames for completion
• Shares goals with the member and family as appropriate
• 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 problems
• Coordinates care and services with the Complex RN Case Manager, and member, family members as appropriate, PCP, Specialist, and Facility/Vendor Providers

Experience

• Able to conduct face to face visits with members local to Shreveport Area/Region 7 based on business need
• 3+ years of clinical practice experience in obstetrics including prenatal and postpartum care
• 1 year of Case Management experience in a hospital, homecare, or remote/telephonic setting
• Case Management experience within a managed care organization (Medicaid/Medicare) preferred
• Certification as a case manager (as documented and accepted on URAC’s website@ ) preferred
• Bilingual language (Spanish) preferred
• Ability to meet deliverables within designated timeframes; strong organization and communication skills
• Demonstrated proficiency working within a Windows 10 environment to include MS Office and electronic medical record and documentation programs
• Personal vehicle with valid driver's license and car insurance required
  
   

Education

• Graduate from an accredited school of nursing. Associate's Degree in Nursing. Bachelor's Degree in Nursing preferred
• Current and unrestricted Registered Nurse in Louisiana or multi-state compact licensure required

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

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