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 from 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.
Responsibilities:
The Care Manager is responsible for acting as a liaison between the behavioral health department and providers / members to provide care coordination and Care management services. ;The Care Manager will be responsible for outreach activity with members and providers. The Care Managers will document all activity in the member’s medical record in the electronic Care management documentation system.
The Care Manager will collaborate with the Clinical Care Managers and the Medical Care Management team in identifying, reviewing and assessing members’ need for behavioral health Care management. The Care Manager will assist in providing Care management services for members who have been enrolled in the program. ;
The Care Manager will screen and facilitate the review outpatient treatment requests within contractual time frames. ;The Care Manager will process behavioral health appeals.
- Provide behavioral health Care management services to Members enrolled in the Select Health Care management program
- Conduct outreach calls and send outreach letters to Members
- Assist Clinical Care Managers and Medical Care Managers in assessing members’ need for Care management services
- Attend Care management meetings
- Collaborate with the medical Care management team, during scheduled meetings and informally as needed
- Complete Health Risk Assessments (HRAs) with members
- Develop care plans (short-term/long-term goals and tasks) and keep them updated
- Outreach to coordinate with PCP and other community providers as needed.
- Identify problems/barriers for care coordination and appropriate Care management interventions to resolve
- Identify barriers to member participation in treatment and solutions to resolve
- Thoroughly document all Care management activity in the member medical record in the electronic Care management documentation system.;
- Participate in ongoing education in regard to the practice of Care management or related skill areas
- Perform other related duties and projects as assigned.
Education/Experience:
- Bachelor's Degree in Nursing or Master's in Social Work. The degree must be from an institution that is fully accredited by a nationally recognized educational accreditation organization and the individual must have completed a supervised field experience in case management, health or behavioral health as part of the degree requirements.
- Current Certification in Case Management (CCM) or eligible to take exam within 24 months of date of hire.
- Must hold a valid, unrestricted State license in a behavioral health specialty or nursing. Acceptable licenses include but are not limited to LMSW, RN, and LPC.
- 3-5 years prior experience in behavioral health/human services required; or other equivalent background and experience that would translate well to this position.
- Customer Service and previous telephone experience preferred, Previous experience in an office setting and/or doctor’s office/ hospital preferred, Knowledge of human services system preferred.
- Strong written and oral communication skills required.
- Ability to perform multiple tasks-required.
- Excellent interpersonal skills-required.
- Excellent organization/time management skills required.
- Ability to work effectively in a team environment required.
- Data Entry/Typing experience.
- PC skills and experience utilizing Microsoft Office required.
Diversity, Equity, and Inclusion
At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
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.
