- Provides access to a single point of contact for all questions or inquiries.
- Conduct assessments with Enrollees and/ or their caregivers.
- Develop 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.
- Provides 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.
- 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.
- A bachelor's (or higher) degree in a health-related field and licensure as a health professional in MI; or Certification as a case manager (as documented and accepted on URAC's website@ ); or Michigan MSW licensure and three (3) years professional practice experience; or Active state Michigan RN license.
- Valid Michigan driver's license with car insurance.
- Current unrestricted Social Worker License.
- 1 to 3 years of 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.
- 3 to 5 years of Case Management experience preferred.
- Ability to communicate with beneficiaries who have medical needs and may have communication barriers, such as those who may require an interpreter, including sign language, or who use assistive technology to communicate.
- Ability to navigate resources and computer systems to access information, including the Medical Management system, online directories, Microsoft Applications, and web-based search engines.
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care coordinator - Southfield, MI , USA, United States - Amerihealth Caritas Health Plan
Description
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 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 would like to connect with 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 atMUST LIVE IN WAYNE OR MACOMB COUNTY, MICHIGAN, TO QUALIFY FOR CONSIDERATION
Responsibilities:
The Care Coordinator (RN/SW) assists members appropriate for care coordination and case management services in achieving their optimal level of health.
Education/Experience:
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.
