Healthcare Leader

Company Overview
AmeriHealth Caritas is a mission-driven organization with over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most.

Salary and Benefits
We offer competitive pay and a comprehensive benefits package, including flexible work solutions, paid time off, and health insurance coverage for you and your dependents on Day 1.

About the Role
The Care Manager II is responsible for managing and coordinating care for Members with acute, chronic, medically complex, and behavioral health conditions. This role involves serving as the primary point of contact for the care team, guiding Members in achieving their optimal level of health through shared decision-making and collaboration with providers and other care team members.

Responsibilities
This role entails the following responsibilities:

• Supporting Members during transitions of care through assessment, coordination, education, referrals, and evaluation of the effectiveness of the plan.
• Reviewing medication lists, educating Members on pharmacy needs, and counseling on side effects and mitigation strategies.
• Evaluating, monitoring, and updating care plans through regular follow-up contacts based on Member/caregiver progress, needs, and preferences.
• Establishing points of contact to collaborate with community, medical, and/or behavioral health teams.
• Maintaining timely, complete, and accurate documentation of Member interactions in electronic care management platforms.
• Monitoring utilization and coordinating services with other payer sources, making referrals, identifying quality of care issues, and escalating them when necessary.
• Developing a working knowledge of electronic care management platforms, care management programs, policies, standard operating procedures, workflows, Member insurance products and benefits, community resources and programs, and applicable regulatory requirements.