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Care Manager II - Bright Start

Company: Amerihealth
Location: Raleigh
Posted on: May 3, 2021

Job Description:



Job Brief

This position will work with our Bright Start program. Pregnancy management experience required. This is a teleworker position but must reside in North Carolina

Your career starts now. Were looking for the next generation of health care leaders.

At AmeriHealth Caritas, were 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, wed like to hear from you.

Headquartered in Philadelphia, 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 .

Responsibilities:

The Bright Start Care Manager RNassistsmembers appropriate for care coordination and case management services in achieving their optimal level of health. The Care Manageris responsible for engaging the member and providers to assess, plan and establish individual member goals. Will facilitate and coordinate care for the pregenant members during pregnancy, including pre and post natal periods 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 care coordination program. Assess members to determine care coordination and case management needs for all referred members. Completes comprehensive assessment of environmental, Psycho-social and support needs. Identifies problems/barriers for care coordination and appropriate care management interventions.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. Identifies and implements the appropriate level of intervention based upon the members 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 Account manager, Complex RN Case Manager, and member, family members as appropriate, PCP, Specialist, and Facility/Vendor Providers

This position will coordinate and address various issues throughout the members' pregnancy. This includes collaborating with pregenant members' obstetricians to coordinate access to needed resources. This is a teleworker position, working with members throughout the entire state of North Carolina. Must reside in the state.

Education/Experience:

  • Certification as a case manager (as documented and accepted on URACs website@ www.urac.org) a plus
  • Active state North Carolina RN license
  • Valid drivers license with car insurance
  • 3-5 years of Case Management preferred.
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Keywords: Amerihealth, Raleigh , Care Manager II - Bright Start, Other , Raleigh, North Carolina

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