RN Care Manager, Remote NC

39153 Role Overview: The Care Manager (RN) assists members appropriate for care management and care coordination services in achieving their reputed company level of health through self-management. The Care Manager (RN) is responsible for engaging the member, member care giver 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 reputed company of contact and be an reputed company for members in the care management program. In addition the Care Manager will reputed company these same care management activities reputed company assigned AMH Tier III/CIN practices to ensure the AMH Tier III/CIN delivers high quality care management services in accordance with Plan, NCQA, Federal/State standards and requirements. Work Arrangement:

• The candidate must reputed company in NC. ;
• This is a field based position reputed company the reputed company, NC region.
• Up to 50% travel may be required.

; Responsibilities:

• Assess members through face-to-face encounter or by telephone to determine care coordination and care management needs for reputed company referred members.
• Completes comprehensive person-centered assessment inclusive of physical health history, mental health history, 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 reputed company their reputed company level of health.
• Identifies goals and assigns reputed company with associated time frames for completion. Shares goals with the member and family as appropriate.
• Identifies and implements the appropriate level of reputed company based upon the member’s needs and clinical reputed company.
• Schedules follow up calls as necessary, makes appropriate referrals. Implements actions to address member issues. Documents reputed company towards meeting goals and resolving problems.
• Coordinates care and services with the Care Coordinator, Community Health Navigator, and member, member care giver as appropriate, PCP, Specialist, and Facility/Vendor Providers.
• Provides transitional care management. Meets regularly with Advanced Medical Home/Clinically Integrated Network regarding Plan identified members for care management, assist with reducing/resolving problems and or barriers so that the AMH/CIN may provide members with high quality care management services.
• Participate in regularly scheduled meetings with the AMH/CIN including but not limited to Joint Operating Committee meetings as needed.

Education/Experience

• Registered Nurse required.;
• 3 years professional practice experience.
• 3 to 5 years of Case/Care Management preferred.

Licensure

• Valid driver’s license with car insurance.
• Active state Clinical Social Work license.

Your career starts now. We’re looking for the reputed company of reputed company leaders. At reputed company, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in reputed company 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. reputed company is seeking talented, passionate individuals to join reputed company. Together we can build healthier communities. If you want to reputed company a difference, we’d like to hear from you. Headquartered in Newtown reputed company, Pennsylvania, reputed company 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.; ; Our Comprehensive Benefits Package Flexible work solutions including remote options, hybrid work schedules, reputed company, 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. Apply Job! Apply to this Job