Job Description

Job Brief

This is a remote position but may require, at times, home visitations to members residing in Philadelphia county.

Your career starts now. We\xe2\x80\x99re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we\xe2\x80\x99re 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\xe2\x80\x99d 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 .

The Care Manager II assists pregnant members appropriate for care coordination services in achieving optimal health throughout pregnancy, delivery, and the postpartum period. The Care Manager II is responsible for engaging the pregnant member and providers to assess, plan and establish individual member goals. The Care Manager II will facilitate and coordinate care for pregnant 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 pregnant members in the Bright Start Maternity program.

Assesses pregnant members to determine care coordination needs. Completes comprehensive assessment of physical, psychosocial, environmental, and support needs. Identifies problems/barriers and implements actions to address member issues/concerns. Creates a plan of care to assist pregnant members in reducing/resolving problems and or barriers so that members may achieve their optimal level of health. Identifies both short- and long-term goals and associated time frames for completion. Shares goals with the member and family as appropriate and documents progress towards meeting goals and resolving problems. Identifies and implements the appropriate level of intervention based upon the member\xe2\x80\x99s needs and clinical progress. Schedules follow up calls as necessary and makes appropriate referrals. Coordinates care and services with member, family members, OBGYN, PCP, Specialists, and Community Based Organizations as appropriate.

Education/Experience:

• This is a remote position but may require, at times, home visitations to members residing in Philadelphia county. Qualified candidates must reside in one of the following zip codes: 19104, 19131, 19139, 19142, 19143, 19145, 19146, 19147, 19148, 19151, 19153, 19172, 19194.
• Current and unrestricted Registered Nurse licensure in Pennsylvania required.
• Graduate from an accredited school of nursing.
• Minimum of 3 years clinical practice experience Labor and Delivery/Mother-Baby/High Risk Ante-Post Partum.
• 3-5 years\xe2\x80\x99 experience as a case manager, preferably providing telephonic case management.
• Certification as a case manager preferred.
• Proficiency using MS Office (Word, Excel, Outlook), internet applications, and electronic medical record and documentation programs.
• Ability to meet deliverables within designated timeframes, strong organization and communication skills.
• Valid driver\xe2\x80\x99s license with car insurance.

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