Care Manager II

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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.

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The Maternity Care Manager provides support to pregnant members appropriate for care coordination and case management services in achieving their optimal level of health through self-management. The Maternity Care Manager 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 throughout the pre- and post-partum period while assuring quality and use of cost-effective resources. The position will function as a a single point of contact and be an advocate for the members through their pregnancy.

Work Arrangement:

• Qualified candidates must reside within a 45 mile radius of Charlotte, NC
• Remote role
• Monday through Friday, 8:30 AM EST to 5:00 PM EST

Requirements:

• Assess members determine care coordination and care management needs for all referred members. Provides support to members through their pregnancy and post partum period.
• Completes comprehensive person centered assessment inclusive of physical health history, psycho-social health, environmental, as well as, social determinants of health and supportive needs.
• Coordinates physical, behavioral health and social services;
• Provides medication management, including regular medication reconciliation and support of medication adherence;
• Identifies problems/barriers for care coordination and appropriate care management interventions.
• 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 family 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, 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 and member caregiver as appropriate, PCP, Specialist, and Facility/Vendor Providers.

Education/Experience:

• Associate Degree in Nursing required; Bachelor Degree preferred
• Minimum of 3 years of maternity experience as a RN, including labor and delivery and high risk antepartum and postpartum care in an acute care setting
• Willing to meet face to face with members in the community, on occasion, based on their needs.
• Minimum of 3 years of Case/Care Management working with Medicaid populations in homecare or community based setting preferred

Licensure

• Active and unencumbered Registered Nurse license in North Carolina
• Valid driver's license with car insurance

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.