Community Care Manager

Role Overview

The Community Care Manager assists members appropriate for care management and care coordination services in achieving their optimal level of health through self-management. The Community Care Manager 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.

Ability to travel within assigned communities in (Montgomery County) in Pennsylvania

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 services

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 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 Care Coordinator, Community Health Navigator, and member, member care giver as appropriate, PCP, Specialist, and Facility / Vendor Providers

Education

Bachelor's Degree in Nursing or health related field preferred.

Current and unrestricted Registered Nurse licensure in Pennsylvania

Experience

3+ years of clinical experience at the bedside (as a Registered Nurse) working with medically fragile pediatric patients in an acute care, home care, or special needs clinic

3+ years of Case Management experience, preferably telephonic within a managed care organization, desired

Eligible to sit for Case Management certification after 12 months of employment. Must obtain this certification after 2 years of employment

Demonstrated proficiency working within a Windows 11 environment to include MS Office (Excel, Word, Outlook) and electronic medical record and documentation programs

Valid driver's license required

Work location and hours

Remote within 1 hour of Montgomery County, Pennsylvania

Ability to travel as needed within Montgomery County communities

Ability to work Monday-Friday from 8 : 30a to 5 : 00p EST

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.

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.

Discover more about us at www.amerihealthcaritas.com.

As a company, we support internal diversity through :

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.