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AmeriHealth Caritas
Care Manager IIAmeriHealth Caritas • Dublin, OH
Care Manager II

Care Manager II

AmeriHealth Caritas • Dublin, OH
17 days ago
Job type
  • Full-time
Job description

Responsibilities

:
  • Assess members to determine eligibility and need for care coordination and case management services.
  • Complete comprehensive, person-centered assessments that evaluate physical health, behavioral health, psychosocial needs, environmental factors, and social determinants of health.
  • Identify clinical, behavioral, and social barriers impacting member health and developing appropriate intervention strategies.
  • Develop, implement, and monitor individualized care plans to improve health outcomes and promote self-management.
  • Establish short- and long-term goals with members and caregivers, including measurable timelines and action plans.
  • Coordinate physical, behavioral, and social services, as well as community-based resources, to meet member needs.
  • Provide medication management support, including medication reconciliation, adherence monitoring, and member education.
  • Implement appropriate care management interventions based on member acuity, needs, and clinical progress.
  • Conduct follow-up outreach, care plan reviews, and ongoing assessments to monitor progress and address emerging needs.
  • Make referrals to internal and external resources as appropriate and facilitate access to services.
  • Document all member interactions, care coordination activities, interventions, and outcomes in accordance with organizational and regulatory requirements.
  • Collaborate with providers, caregivers, and interdisciplinary teams to ensure continuity of care and successful care transitions.
  • Support members experiencing complex conditions, including behavioral health disorders, chronic conditions, maternal health needs, oncology diagnoses, and transition-of-care needs.

Education & Experience:

  • Associate degree in nursing required.
  • Bachelor of Science in Nursing preferred.
  • Master’s degree in Social Work required.
  • 3 years of professional clinical experience working with adult and/or pediatric populations in one or more of the following areas: Behavioral Health, Physical Health, Oncology, Care Transitions/Discharge Planning, Community Health, Ambulatory Care, or Acute Care
  • Previous case management or care coordination experience preferred.
  • Experience within a managed care organization is highly preferred.
  • Demonstrated experience assessing member needs, developing care plans, coordinating services, and promoting self-management.
  • Ability to work independently while managing multiple priorities in a fast-paced environment.

Licensure:

  • Current, active, and unrestricted Ohio Registered Nurse (RN) license.
  • Current, active, and unrestricted Ohio license in good standing as one of the following:
  • Licensed Social Worker (LSW), Licensed Master Social Worker (LMSW), Licensed Independent Social Worker (LISW), or Licensed Professional Counselor (LPC)
  • Valid driver's license and car insurance.

Skills & Abilities:

  • Strong knowledge of care management, care coordination, case management, and population health principles.
  • Ability to perform comprehensive member assessments and develop effective care plans.
  • Knowledge of social determinants of health and community-based resources.
  • Strong clinical judgment and critical thinking skills.
  • Ability to prioritize, organize, and manage multiple cases simultaneously.
  • Excellent time management and follow-through skills.
  • Strong communication and relationship-building skills with members, caregivers, providers, and community partners.
  • Ability to work independently while collaborating effectively within a multidisciplinary team.
  • Strong documentation and navigation skills for care management systems.
  • Proficiency with electronic medical records (EMR), care management platforms, and Microsoft Office applications.
  • Flexible, adaptable, and comfortable working in a dynamic and evolving healthcare environment.
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Care Manager II • Dublin, OH

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