Hybrid Care Manager Sr na AmeriHealth Caritas

Discover more about us at www.amerihealthcaritas.com.

Role Overview:
Under the supervision of the Supervisor of the Integrated Care Management Department, the Care Manager Senior is responsible for assisting the supervisor in the daily operations of the department, including but not limited to, training and mentoring new and existing associates, participating in workflow and policy development, reviewing referrals for appropriateness, and assigning episodes as needed.  Practices case management within the scope of their licensure (based on the standards of the discipline).

Work Arrangement:
·        Travel within the State of Delaware will be required.

Responsibilities:
Performs and remains knowledgeable in all workflow and timeliness requirements for all disciplines of the Integrated Care Management Department. Manages a portion of a standard case load per Plan needs and provides coverage for absent care managers as directed by management, fulfilling all responsibilities of a care manager. Demonstrates ability to make recommendations impacting care assessment, access and delivery in the Integrated Care Management department, including but not limited to, conducting in person, virtual, or telephonic case management screening, appropriate communication with members, and case management/disease management. Demonstrates ability to act as a resource in addressing clinical and technical issues.  Demonstrates and maintains a current knowledge of State and federal requirements, licensing and regulating agency requirements, e.g., NCQA and URAQ standards.

Experience/Education:
•    A minimum of 3 or more years of Case Management experience required
•    Case Management at a Managed Care Organization experience preferred
•    Experience training new staff preferred 
•    Maintenance of necessary educational requirements to maintain professional licensure and certifications

Licensure:
•    Valid driver’s license with car insurance 
•    Current unrestricted Delaware Registered Nurse License or unrestricted State Social Work License for the appropriate State as determined by management.   

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.

 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.