AmeriHealth Caritas Care Coordinator Medicare in Southfield, Michigan

Care Coordinator Medicare


Description

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 Philadelphia, 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:

Field Base / Work from Home Opportunity

The Care Coordinator (RN/SW) assists members appropriate for care coordination and case management services in achieving their optimal level of health. The Care Coordinator (RN/SW) must have relevant experience and education to work with Enrollees with complex health, behavioral health, long-term services and supports and/or psychosocial needs and perform the following functions:

  • Provides access to a single point of contact for all questions or inquiries.
  • Conducts assessments with Enrollees and/ or their care giver.
  • Develops an Individualized Care Plan that is periodically reviewed and updated.
  • Provides disease self-management and coaching.
  • Conducts medication review, including reconciliation during transitions of care setting.
  • Providess periodic monitoring of health, functional and mental status along with pain and fall screening.
  • Ensures the provision of services in the least restrictive setting and transition support across and between specialties and care settings.
  • Connects Enrollees to services that promote community living and help to delay or avoid nursing facility placement.
  • Coordinates with social service agencies (e.g., local departments of health, social services and community based organizations) and the referral of Enrollees to state, local and/or other community resources; and
  • Collaborates with nursing facilities to promote adoption of evidence-based interventions to reduce avoidable hospitalization, management of chronic conditions, medication optimization, fall and pressure ulcer prevention, and the coordination of services beyond the scope of the nursing facility benefit.

Education/Experience:

  • A bachelors (or higher) degree in a health related field and licensure as a health professional (where such licensure is available); or
  • Certification as a case manager (as documented and accepted on URAC’s website@ www.urac.org); or MSW licensure and three (3) years professional practice experience; and
  • Active state RN license in MI or current unrestricted Social Worker License
  • 75% home visits based upon business needs.
  • Valid driver’s license
  • Social services and/or clinical experience working with complex populations, including those with physical health, behavioral health, long-term services and supports and/or psychosocial needs.
  • Three to five years of Case Management preferred.