Manager Integrated Care Management, BSN or LMSW (South Carolina)

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 Newtown Square, 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 .

Must reside in the state of South Carolina

Responsibilities:

Under the supervision of the Director Clinical Market Population Health, the Manager of Integrated Care Management is responsible for the daily operations of the Complex Care Management and Behavioral Health teams. Responsible for compliance with State and Federal laws and business plan goals.

• Plans, organizes and directs the development and implementation of Case Management operations. Ensures staff is properly trained, oriented and provided with regular professional development. Identifies opportunities for improvement, both clinical and administrative, and assists the Director in the strategic planning processes for these functions.
• Coordinates and implements the development of recommended policies and programs. Coordinates, establishes and monitors achievement of departmental goals and objectives. Responsible for achievement of assigned NCQA standard compliance and compliance with all applicable State and Federal laws, as well as achievement of assigned incented health outcomes.
• Directs effectiveness of existing programs and services, identifies and evaluates new programs and services to address cost effectiveness, proposed process improvements and to achieve compliance with NCQA, CMS and State incented health outcomes.
• Participates in and supports the corporate Population Health Strategy.
• Directs the case management activities to be in compliance with the state Department of Health and Human Services (DHHS) requirements for case management.
• Works across departmental lines to achieve objectives.
• Creates and supports an environment that fosters teamwork, cooperation, and respect. Establishes and maintains positive communication and professional demeanor with employees, providers and acts as liaison with outside entities as required. Demonstrates and supports commitment to corporate goals and mission.
• Performs other related duties and projects as assigned.

Education/ Experience:

• Must reside in South Carolina.
• Bachelor’s Degree in Nursing or other health related field required.
• Current and unrestricted Registered Nurse license in South Carolina strongly preferred
• MSW and current and unrestricted LICSW/LSW in South Carolina (in lieu of RN license).
• 3 years professional clinical practice experience in behavioral health and/or adult/pediatric populations.
• 8 years progressive leadership experience to include 5 years of experience within a managed care organization.
• Experience managing a large team of remote licensed and unlicensed associates.
• Experience leading projects with internal and external stakeholders.
• Care management experience in a clinical managed care environment required, preferably within a Medicaid business unit.
• Ability to travel to Columbia, SC and Charleston, SC based on business needs.
• Valid Driver's License.

Diversity, Equity, and Inclusion

At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, 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.