AmeriHealth Caritas Long-Term Services & Support Case Manager in Dover, Delaware

Long-Term Services & Support Case Manager


Description

AmeriHealth Caritas Delaware is excited to have been chosen as one of the Medicaid managed care plans for the Diamond State Health Plan and Diamond State Health Plan- Plus programs. Backed by a national organization, we have long-term experience serving the Medicaid population in neighboring states. We are committed to delivering health care through innovative services and programs and are looking forward to helping Delaware become an even healthier state.

Responsibilities:

As part of the Community-based Care Management program, the Community Care Manager assists members appropriate for care coordination and case management program services in a community setting. The Community Care Manager collaborates with all levels of the Medical Management department for appropriate integration of Community Based Medical Management programs and with other existing and planned initiatives in order to align with annual operating plan and strategic growth initiatives. The Community Care Manager performs the following functions:

  • Provides access to a single point of contact for member questions or inquiries;
  • Conducts in-home environmental and physical assessments for high risk members to identify unmet needs and barriers to care;
  • Develops an Individualized Care Plan that is periodically reviewed and updated;
  • Provides disease self-management and coaching;
  • Ensures the provision of services in the lease restrictive setting and transition support across and between specialties and care settings;
  • Connects members to services that promote community living and help to delay or avoid nursing facility placement;
  • Establishes points of contact in order to collaborate with identified community, medical and/or behavioral health teams;
  • Works closely with and directs and supervises the work of the Community Care Connectors as they deliver in-community care support pathways to establish connections to appropriate services;
  • May serve as a program subject matter expert and/or assist the Community Care Program Manager with operational responsibilities.

Education/Experience:

  • Bachelor’s Degree
  • LTSS experience required.
  • Assist members in identifying resources and providers to ensure members’ needs are met.
  • Ability to travel extensively within assigned communities. Valid driver’s license required