Care Manager II, BSN/LICSW (must be local to DC Metro area)

Responsibilities

The Care Manager II (Registered Nurse / Licensed Independent Clinical Social Worker) assists members with complex medical needs appropriate for care coordination and case management services in achieving their optimal level of health through self-management.

The Care Manager II (RN / LICSW) is responsible for engaging the member, member caregiver, and providers to assess, plan, and establish individual member goals.

Will facilitate and coordinate care for the 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 members in the care coordination program.

• Assess members to determine care coordination and case management needs for all referred members. Works with both adults and children with complex medical needs
• Completes comprehensive person-centered assessment of physical health, psycho-social health, environmental, as well as social determinants of health and supportive needs.
• Identifies problems / barriers for care coordination and appropriate care management interventions.
• Coordinates physical, behavioral health and social services.
• Provides medication management, including regular medication reconciliation and support of medication adherence.
• Creates a plan of care to assist 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 caregiver as appropriate.
• Identifies and implements the appropriate level of intervention based upon the member’s needs and clinical progress.
• Schedules follow-up calls as necessary and makes appropriate referrals. Implements actions to address member issues. Documents progress towards meeting goals and resolving problems.
• Coordinates care and services with the Care Coordinator, Community Health Navigator, and member, member caregiver as appropriate, PCP, Specialist, and Facility / Vendor Providers.

Education / Experience :

AmeriHealth Caritas utilizes a hybrid work environment with associates working from home two days a week and in the office three days a week.

The functions of this position will be performed onsite at our offices located at 445 12th St. SW, Washington, D.C., 20024.

• Qualified candidates must reside in the DC Metro area.
• Required for RN candidates : Current and unrestricted Registered Nurse licensure in the District of Columbia and a Bachelor's Degree in Nursing.
• Required for LICSW candidates : Current and unrestricted Licensed Independent Clinical Social Worker (LICSW) licensure in the District of Columbia and a Master's Degree in Social Work.
• Minimum of 3 years of clinical practice experience as a RN or LICSW working with adults and / or pediatrics with complex medical and behavioral health diagnoses within an acute care, homecare or community health setting.
• Minimum of 1 years of case management experience supporting Medicaid members within a managed care organization preferred.
• Must be willing to meet face to face with members in their homes, providers' offices, or in a hospital setting on a monthly basis.
• Bilingual English / Spanish or English / Amharic preferred.
• Must have a current Driver's License.

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 of employment, 401(k) Tuition reimbursement and more.

The range displayed in this job posting reflects the minimum and maximum for new hire salaries for the position in the Washington, DC area.

Within the range, individual pay is determined by additional factors, including, without limitation, job-related skills, experience, and relevant education, certifications, or training.

AmeriHealth Caritas associates are eligible to participate in our annual incentive program and will also receive our benefits package, consisting of medical, vision, dental, life insurance, disability insurance, 401(k), paid time off and more.

The targeted hiring range for this role is expected to be between $78,600 and $107,100.

PH #HM

Generous paid time off and paid volunteer time off.

Employer-matched 401(k) and additional non-elective contributions, starting on day one.

Medical, dental, and vision plans with coverage starting on day one.

Employee assistance programs, fitness reimbursements, nutrition counseling, and more.

Employer-paid life insurance, with opportunities to purchase additional coverage.

Employer-paid short-term disability coverage and long-term disability coverage.

Tuition assistance, including reduced tuition at certain schools.

Financial assistance with adoption, including paid time off.

Flexible spending and health savings accounts to pay for qualified expenses.

Discount programs on entertainment, travel, and more.