What are the responsibilities and job description for the Healthcare Leader position at Amerihealth Caritas?
Transforming Lives through Compassionate Care
AmeriHealth Caritas is a mission-driven organization dedicated to helping people get care, stay well and build healthy communities. We are passionate about empowering the next generation of healthcare leaders to make a positive impact in the lives of millions.
As a Field-Based Remote Behavioral Health Case Worker, you will play a vital role in managing and coordinating care for members with behavioral health conditions and acute, chronic, and medically complex needs. You will serve as the primary point of contact for the care team, utilizing strong assessment and communication skills to identify issues, gaps in care, and barriers to care.
Key Responsibilities:
- Support members during transitions of care through assessment, coordination of care, education of the discharge plan of care, referrals, and evaluation of the plan's effectiveness.
- Review medication lists and help members coordinate pharmacy needs with community pharmacists to ensure medication reconciliation is completed when changes occur.
- Evaluate, monitor, and update care plans through regularly scheduled follow-up contacts based on member progress, needs, and preferences.
- Establish points of contact to collaborate with identified community, medical, and/or behavioral health teams.
- Maintain timely, complete, and accurate documentation of member interactions in ACFC electronic care management platforms where applicable.
- Monitor appropriate utilization and coordinate services with other payer sources, make appropriate referrals, and identify and escalate quality of care issues.
- Develop a working knowledge of ACFC electronic care management platforms, care management programs, policies, standard operating procedures, workflows, member insurance products and benefits, community resources and programs, and applicable regulatory, state, and NCQA requirements.
- May identify cases to be presented at care management rounds and follow up with providers on recommendations to achieve optimal outcomes for members.
- Support a positive workplace environment, collaborate, and share clinical knowledge and skills to support our culturally and demographically diverse member population.
- Conduct face-to-face visits at member residences, provider offices, hospitals, or community locations for education and/or assessment.
- Other duties as assigned.
