Hybrid Care Manager (RN/LICSW) bei Enlightened

Company Overview:

As one of the Washington Metropolitan-area’s fastest growing IT companies, we are always looking for creative, passionate and responsible employees. We acknowledge that intelligent, dedicated employees are our greatest asset and are continuously adding to our talented and diverse team. If you feel innovation, integrity and a drive to deliver are key components to success, we invite you to become Enlightened.

Position Overview:

What We’re Looking For…
Licensed Registered Nurses (RN) or Clinical Social Workers (LICSW) to serve as Care Managers supporting the AmeriHealth Caritas DC clinical support team in Washington, DC. The position will assist enrollees appropriate for care coordination and case management services in achieving their optimal level of health. Care Managers are needed for the following programs:

• Bright Start Maternity – serves pregnant enrollees throughout the pre- and post-natal period, as well as our NICU infant population
• Complex Care Management – provides care management to enrollees across the lifespan living with complex medical needs 
• Early Intervention - provides support and services to families with children, birth to age 3, with developmental delays and disabilities

The ideal candidate will have at least three (3) years of professional practice experience. The role is hybrid. All associates are required to be on site at our office in SW DC on Monday’s and are required to complete face-to-face engagements with our enrollees in the community.

Position Responsibilities:

The Care Manager (RN/LICSW) is responsible for engaging with enrollees, their caregivers, and providers to assess, plan, and establish individual enrollee goals. The role will facilitate and coordinate care for enrollees throughout the pre- and post-partum periods, ensuring quality and cost-effective resource utilization.  

• Assess enrollees to determine care coordination and case management needs for all referred enrollees.
• Complete comprehensive person-centered assessments covering physical health, psychosocial health, environmental factors, social determinants of health, and supportive needs.
• Identify problems and barriers to care coordination and implement appropriate care management interventions.
• Coordinate physical, behavioral health, and social services.
• Provide medication management, including regular reconciliation and support for medication adherence.
• Develop care plans to help enrollees reduce or resolve problems and barriers, enabling them to achieve optimal health.
• Establish short- and long-term goals with associated time frames, sharing these goals with enrollees and caregivers as appropriate.
• Identify and implement appropriate interventions based on enrollee needs and clinical progress.
• Schedule follow-up calls as necessary, make referrals, and take action to address enrollee issues. Document progress toward goals and problem resolution.
• Coordinate care and services with Care Coordinators, Community Health Navigators, enrollees, caregivers, Primary Care Physicians (PCPs), specialists, and facility/vendor providers.

Required Qualifications:

Qualified candidates must reside in the DC Metro area (District of Columbia residents strongly preferred).Active DC RN or current unrestricted LICSW license.

• Bachelor's degree or higher in a health-related field preferred
• Case manager certification preferred (as documented and accepted on URAC’s website at www.urac.org).
• 3 to 5 years of nursing/social work experience required, including working with Medicaid populations in hospital or community health settings.
• 3 to 5 years of experience working with adult and/or pediatric populations with complex medical and behavioral health needs required.
• 3 to 5 years of case management experience preferred.
• Willingness to meet face-to-face with enrollees in the community based on business needs.
• Bilingual English/Spanish or English/Amharic preferred.

Benefits:

The expected salary range for this position is listed above.  Actual compensation will be determined based on experience and qualifications as well as internal equity and alignment with market data. 

At Enlightened, we pride ourselves on offering a comprehensive and industry-competitive benefits package to our full-time employees. Our benefits include:  

• Medical/Dental/Vision Insurance with Health Savings Accounts (HSA)
• Flexible Spending Accounts (FSA)
• 401(k) Retirement Plan
• Paid Holidays, Vacation, & Sick Leave
• Professional Training & Development Reimbursement  

Please note, these benefits are available exclusively to full-time employees of Enlightened.