Responsibilities
As a Care Manager II, you’ll be empowered to lead the charge in improving health outcomes. You’ll monitor and update care plans based on real-time feedback from members and caregivers, continuously refining your approach to ensure it meets their evolving needs.
Your role will involve close collaboration with other healthcare professionals, making you a vital link in the chain of care that keeps members on the path to health.
Your contributions will also be recognized and valued within a supportive workplace culture that prioritizes collaboration, learning, and professional growth.
You’ll share your clinical knowledge and expertise with your peers, helping to elevate the standard of care across the board.
To excel in this role, you’ll need a Bachelor of Science in Nursing (BSN) and an unrestricted RN license in South Carolina (or a compact state).
Your background in pediatric home care or acute care will give you the experience needed to manage the unique challenges of this position.
If you’ve worked within the Foster Care System, Department of Social Services, or Department of Juvenile Justice, you’ll have a distinct advantage in understanding the complex needs of some of our most vulnerable members.
And of course, you’ll need to be comfortable navigating the digital landscape, with proficiency in MS Office and electronic medical records, ensuring that all member interactions are documented accurately and efficiently.
Are you ready to take on a role where your nursing expertise and passion for helping others can truly shine? Step into the Care Manager II position and make a difference in the lives of those who need it most.
This isn’t just a job it’s a calling to be the compassionate guide and relentless advocate that every member deserves.
Position Overview :
- Support Members during transitions of care through assessment, coordination of care, education of the discharge plan of care, referrals, and evaluation of the effectiveness of the plan.
- Review medication list and educate Members with pharmacy needs, and counsel on side effects and mitigation strategies for specific treatment protocols.
- Evaluate, monitor, and update the care plan through regularly scheduled follow-up contacts based on the Member / caregiver progress, needs and preferences.
- Establishes points of contact in order to collaborate with identified community, medical, and / or behavioral health teams.
- Maintain timely, complete, and accurate documentation of Member interactions in ACFC electronic care management platforms where applicable.
- Monitor appropriate utilization and coordinate services with other payer sources, make appropriate referrals, identify and escalate quality of care issues.
- Develop a working knowledge of ACFC electronic care management platforms, care management programs, policies, standard operating procedures, workflows, Member insurance products and benefits, community resources and programs, and applicable regulatory, state, and NCQA requirements.
- May identify cases to be presented at care management rounds and follows up with providers on recommendations to achieve optimal outcomes for Members.
- Support a positive workplace environment, collaborate, and share clinical knowledge and skills to support our culturally and demographically diverse Member population.
- Face-to-face visits may be required at the Member’s residence, provider’s office, hospitals, other acute location or community location for education and / or assessment.
- Other duties as assigned.
Education Overview :
Remote to qualified candidates living in South Carolina only.Bachelor of Science in Nursing (BSN) is required and must hold a current and unrestricted Registered Nurse (RN) license in good standing in South Carolina or a compact state.
A minimum of 3 years of professional experience in pediatric home care or acute care is required.Prior experience in the Foster Care System, Department of Social Services, or Department of Juvenile Justice as an RN is preferred.
Must engage directly with identified members through face-to-face visits in the community as needed.At least 3 years of case management experience is preferred.
Proficiency in MS Office (Word, Excel, Outlook, Teams), internet applications, and electronic medical record / documentation systems is essential.
A valid driver’s license with car insurance is required.
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, 401(k) Tuition reimbursement and more.
Generous paid time off, including holidays and volunteer events.
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.
Registered Nurse (RN) Acute Care, Facility Resource Pool, Hillcrest, FT, Nights
Includes planning for discharge to assure continuity of care and a smooth transition post discharge from one level of care to another including appropriate referrals. Working for the Facility Resource Pool, provides clinical direction for all aspects of patient care in an acute inpatient setting, fo...
Registered Nurse (RN) - Hospital Care Manager, PRN
The Hospital Care Manager (HCM) is an integral care team partner that focuses on patient engagement and activation, has primary accountability for patients' care transition out of the acute care setting and positively impacts longitudinal care plan alignment. Ensures clear documentation for the inte...
Registered Nurse (RN) Acute Care, Medical Telemetry, PRN, Nights
Includes planning for discharge to assure continuity of care and a smooth transition post discharge from one level of care to another (to include appropriate referrals). In lieu of 1 year of registered nurse experience, will accept successful completion of the Prisma Health Nurse Residency Program o...
Registered Nurse (RN) - Acute Care, General Medicine, FT, Day
Includes planning for discharge to assure continuity of care and a smooth transition post discharge from one level of care to another (to include appropriate referrals). In lieu of 1 year of registered nurse experience, will accept successful completion of the Prisma Health Nurse Residency Program o...
Registered Nurse (RN) Acute Care, ICU Intermediate, FT, Nights
Includes planning for discharge to assure continuity of care and a smooth transition post discharge from one level of care to another (to include appropriate referrals). In lieu of 1 year of registered nurse experience, will accept successful completion of the Prisma Health Nurse Residency Program o...
Registered Nurse (RN) - Acute Care, CVICU, FT, Night
Includes planning for discharge to assure continuity of care and a smooth transition post discharge from one level of care to another (to include appropriate referrals). In lieu of 1 year of registered nurse experience, will accept successful completion of the Prisma Health Nurse Residency Program o...
Registered Nurse (RN) - Ambulatory, Primary Care North Greenville, FT, Day
Licensed to practice as a Registered Nurse in South Carolina. Provides routine, standardized nursing care for patients under the supervision of the physician. Assists physicians with examinations, procedures and other activities related to direct patient care. Calls in prescriptions for patients acc...
Registered Nurse (RN)
As a registered nurse on our team, you’ll evaluate patients and create care plans, all while communicating with everyone involved — the patient, the patient’s family, and the care team. A leading hospice, palliative, and pediatric comfort care provider, Agape Care Group is dedicated to serving patie...
Registered Nurse (RN) - Acute - Long Term Acute Care - Part-Time Day
Includes planning for discharge to assure continuity of care and a smooth transition post discharge from one level of care to another (to include appropriate referrals). In lieu of 1 year of registered nurse experience, will accept successful completion of the Prisma Health Nurse Residency Program o...
Licensed Practical Nurse (LPN) Acute Care, Medical Telemetry, FT, Nights
Under the direction of a Registered Nurse/Physician, provides nursing care for patients. Under the direction of a Registered Nurse/Physician, provides nursing care for patients. Performs additional patient care functions for which appropriately licensed. Performs additional patient care functions fo...