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Full-time
bachelor degree
Flexible Work Solutions, Remote Options, Hybrid Work Schedules, Competitive Pay, Paid Time Off, Holidays
Posted 23d ago
~40 hrs/week
Responsibilities
Manage and coordinate care for members with acute, chronic, and complex health conditions to improve health status and promote self-management. Serve as the primary point of contact for the care team, conducting assessments and facilitating transitions of care through community and medical collaboration.
Requirements
Requires a Bachelor of Science in Nursing (BSN) and a current, unrestricted RN license in South Carolina or a compact state. Minimum of 3 years of professional experience in a related field is required, with case management experience preferred.
Full job description
Role Overview: Care Manager II (Field-Based, Remote)
Responsible for managing and coordinating care, services, and social determinants of health for Members with acute, chronic, medically complex, and behavioral health conditions and other health needs. Serves as the primary point of contact for the care team that includes Members, physicians as well as community supports to guide members in achieving their optimal level of health. Utilizes strong assessment and communication skills, critical thinking, and clinical knowledge to identify issues, gaps in care and barriers to care. The Care Manager II develops a plan of care through shared decision making with the Member/caregiver and in collaboration with providers and other care team members to improve the Member’s health status, compliance with treatment plans and promote self-management.
Responsibilities:
Support Members during transitions of care through assessment, coordination of care, education of the discharge plan of care, referrals, and evaluation of the effectiveness of the plan
Review medication list and educate Members with pharmacy needs, and counsel on side effects and mitigation strategies for specific treatment protocols
Evaluate, monitor, and update the care plan through regularly scheduled follow-up contacts based on the Member/caregiver progress, needs and preferences
Establishes points of contact in order to collaborate with identified community, medical, and/or behavioral health teams
Maintain timely, complete, and accurate documentation of Member interactions in ACFC electronic care management platforms where applicable
Monitor appropriate utilization and coordinate services with other payer sources, make appropriate referrals, identify and escalate quality of care issues.
Develop a working knowledge of ACFC electronic care management platforms, care management programs, policies, standard operating procedures, workflows, Member insurance products and benefits, community resources and programs, and applicable regulatory, state, and NCQA requirements
May identify cases to be presented at care management rounds and follows up with providers on recommendations to achieve optimal outcomes for Members
Support a positive workplace environment, collaborate, and share clinical knowledge and skills to support our culturally and demographically diverse Member population
Face-to-face visits may be required at the Member’s residence, provider’s office, hospitals, behavioral health facilities, and other acute location or community location for education and/or assessment.
Education and Experience:
Bachelor of Science in Nursing (BSN) is required.
Minimum of 3 years of professional experience in related field required (i.e., pediatrics, home care, acute care, etc.)
Prior experience in the Foster Care System, Department of Social Services, or Department of Juvenile Justice as an RN is preferred
Must engage directly with identified members through face-to-face visits in the community as needed
At least 3 years of case management experience is preferred
Proficiency in MS Office (Word, Excel, Outlook, Teams), internet applications, and electronic medical record/documentation systems is essential
Licensure:
Must hold a current and unrestricted Registered Nurse (RN) license in good standing in South Carolina or a compact state
Travel required. Must have valid driver's license, reliable transportation and auto insurance.
Our Comprehensive Benefits Package: Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents starting Day 1, 401(k) retirement savings plan, tuition reimbursement, and more.
Why Join Us: Your career starts now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare 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 are driven to make a difference, we want to hear from you.
About AmeriHealth Caritas Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. Our services include integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at http://www.amerihealthcaritas.com
Related keywords
Registered NurseRNBSNCase ManagementCare ManagementNCQAElectronic Care Management PlatformsSocial Determinants of HealthBehavioral HealthPatient AdvocacyCare PlanHealthcare SolutionsManaged CareMedical ComplexitiesCommunity Resources
Our mission at AmeriHealth Caritas New Hampshire is to help people:
Get care.
Stay well.
Build healthy communities.
Industry
Hospitals and Health Care
Company size
51-200 employees
Headquarters
Manchester, New Hampshire
LinkedIn followers
268
At AmeriHealth Caritas New Hampshire, we're passionate about helping people get care, stay well, and build healthy communities. We are located in Manchester, NH and serve Medicaid recipients throughout the entire state of New Hampshire.
AmeriHealth Caritas New Hampshire is part of the AmeriHealth Caritas Family of Companies. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 35 years of experience delivering 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 support services. In the process, we are dedicated to helping find solutions to end poverty so the American Dream is in reach for all.
Offices: 25 Sundial Ave, 1st Floor, Manchester, New Hampshire 03103, US
healthcaremedicaidhealth insurancepublic healthand new hampshire
How much do Social Services jobs in North Carolina pay?
Based on 969 listings with disclosed salaries, most social services jobs in North Carolina pay between $47k–$105k per year. Individual offers vary with seniority, company size, and specialization.
How many Social Services jobs are open in North Carolina right now?
There are currently 6,029 open social services positions in North Carolina listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Social Services roles in North Carolina?
Companies currently hiring include BAYADA Home Health Care, North Carolina Department of Environmental Quality, WCPSS Lifelong Learning with Community Schools, RHA Health Services, LLC, Monarch, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Social Services jobs in North Carolina?
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How do I apply for Social Services jobs in North Carolina?
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