Care Manager II

Full Time
Southfield, MI 48076
Posted
Job description

Your career starts now. We’re looking for the next generation of health care leaders.

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 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 www.amerihealthcaritas.com.

Responsibilities:

Under the Supervision of the Manager of Care Management, the Care Manager is responsible for the overall accountability for the identification of members appropriate for care management services. Completes a comprehensive Initial Assessment and gathers pertinent information about the member’s needs by interviewing the member or making home/facility visits, appropriate family members, physicians and other members of the Interdisciplinary Care Team to develop, monitor and evaluate the member’s Individualized Care Plan and update as needed. Serve as an advocate for the member and acts as a liaison between the member and other community based agencies, facilities, providers, and practitioners in coordinating the member’s care. Coordinates and performs transition planning for members transitioning between levels of care. Monitors appropriate utilization of the member’s benefits and coordinates services with other payer sources. Perform all other duties and projects as assigned.

Education/ Experience:

  • Bachelor’s Degree Desirable but not required.
  • Master’s Degree/SW.
  • LSW(Licensed social worker).
  • Registered Nurse.
  • 1 to 3 years Care Management experience; must have relevant experience/education to work with members with complex health, behavioral health, and sup ports and/or psychosocial needs.
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