Community Care Manager

Location: Palm Beach Gardens, FL

Primary Job Function: Medical Management

ID**: 34239

Job Brief

AmeriHealth Caritas Florida is seeking an experienced Medicaid Community Care Manager with Pediatric Complex experience. 60% travel required in/around AHCA Region 9/G, Region 10/H & Region 11/I.

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nations 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 would like to hear 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.

Responsibilities:

As part of the Community-based Care Management program, the Community Care Manager collaborates broadly for the identification of members/consumers appropriate for care coordination and/or case management program services in a community setting. The Care Manager collaborates with all levels of Medical Management department staff for appropriate integration of Community Based Medical Management programs with other existing and planned initiatives, aligning with annual operating plan and strategic growth initiatives. The Care Manager provides in home environmental and physical assessments for high risk members to identify unmet needs and barriers to care and to establish a care management plan of care. The Care manager may provide basic clinical care within scope of practice in collaboration with members medical management team. Establishes point of contacts in collaboration with member community medical/behavioral health teams. Works closely with and directs and supervises the work of Community Care Connectors as they deliver in-community care, support pathways to establish connections to appropriate services and provide coaching and education for chronic disease management. May serve as a program subject matter expert and/or assist the Community Care Program Manager with operational responsibilities.

Education/Experience:

• State of Florida Registered Nurse (RN) with at least two years Pediatric experience with medically complex children, or have a Masters Degree in Social Work (MSW) and be a Licensed Clinical Social Worker (LCSW) in the state of Florida with at least one year of related professional experience with medically complex children required.

• Minimum of three years of similar level or related experience including demonstrated expertise conducting health assessments and delivering care in a clinical and community environment.

• Prior experience in leading teams in a matrixed environment

• Requires completion of medical exam/testing as required by Federal and State regulations upon conditional offer of employment and post-employment.

• Proficient in MS Office (Word, Excel, and Outlook) within a Windows-based environment, Internet applications, electronic medical records (EMRs), and electronic documentation programs.

• Ability to travel extensively within assigned communities in Florida. Valid driver’s license required.

• Must reside in the Palm Beach or St. Lucie Florida Counties.

• Must be able to complete monthly face-to-face visits in the member's homes, Pediatric Skilled Nursing Facilities and/or PPEC.

• Valid Drivers License, automobile registration and insurance required.

• 60% travel required in/around AHCA Region 9/G, Region 10/H & Region 11/I.

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.

EOE Minorities/Females/Protected Veterans/Disabled