Care Manager II, Medicare, RN/LICSW/LSW
Company: Amerihealth Caritas Health Plan
Location: Charleston
Posted on: June 24, 2022
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Job Description:
This role is eligible for a $2,500 sign-on bonus for external
candidates
Responsibilities:
The Care Manager (RN/SW) assists members appropriate for care
coordination and case management services in achieving their
optimal level of health. The Care Manager (RN/SW) 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.
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 Account
manager, Complex RN Case Manager, and member, family members as
appropriate, PCP, Specialist, and Facility/Vendor Providers.
* The Care Manager (RN/SW) assists members appropriate for care
coordination and case management services in achieving their
optimal level of health.
* The Care Manager (RN/SW) 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.
* 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 Account manager, Complex
RN Case Manager, and member, family members as appropriate, PCP,
Specialist, and Facility/Vendor Providers.
Education/Experience:
* This role is a remote role that will require in person meetings
with our members. Qualified candidates must reside in South
Carolina.
* A Bachelor's (or higher) degree in a health related field and
licensure as a health professional (where such licensure is
available)
* Graduate of accredited RN program and current and unrestricted
Registered Nurse licensure in South Carolina OR MSW with current
and unrestricted LICSW/LSW licensure in South Carolina and three
(3) years professional practice experience
* 3-5 years Case Management experience preferred
* Certification as a case manager (as documented and accepted on
URAC's website@ www.urac.org)
* Valid driver's license with car insurance
Keywords: Amerihealth Caritas Health Plan, Charleston , Care Manager II, Medicare, RN/LICSW/LSW, Healthcare , Charleston, South Carolina
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