- Assess members to determine care coordination and case management needs for all referred members. Provides support to members throughout their pregnancy and postpartum period.
- Completes comprehensive person-centered assessment of physical health, psycho-social health, environmental, as well as social determinants of health and supportive needs.
- Identifies problems/barriers for care coordination and appropriate care management interventions.
- Coordinates physical, behavioral health and social services.
- Provides medication management, including regular medication reconciliation and support of medication adherence.
- Creates a plan of care to assist members in reducing/resolving problems and or barriers so that members may achieve their optimal level of health.
- Identifies both short- and long-term goals and associated time frames for completion. Shares goals with the member and caregiver as appropriate.
- Identifies and implements the appropriate level of intervention based upon the member's needs and clinical progress.
- Schedules follow up calls as necessary, makes appropriate referrals. Implements actions to address member issues. Documents progress towards meeting goals and resolving problems.
- Coordinates care and services with the Care Coordinator, Community Health Navigator, and member, member care giver as appropriate, PCP, Specialist, and Facility/Vendor Providers.
- 3+ years of Case Management preferred
- Demonstrated maternal/child health experience and/or experience working with pregnant patients, pediatric patients, etc.
- Active DC RN or SW license
- A bachelors (or higher) degree in a health-related field and licensure as a health professional (where such licensure is available)
- District of Columbia (DC) Certification as a Case Manager (as documented and accepted on URAC's website@ )
- Willing to meet face to face with members in the community, on occasion, based on business needs
- Bilingual English/Spanish/Amharic highly desired
- Medical/Dental/Vision Insurance w/Health Savings Accounts (HSA)
- Flexible Spending Account(s) (FSA)
- 401(k) Retirement Plan
- Paid Holidays, Vacation, & Sick Leave
- Professional Training & Development Reimbursement
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Care Manager - Washington, United States - Enlightened, Inc.
Description
Job Description
Job DescriptionLICENSED CARE MANAGER (RN/SW)
***$5000 Hiring Bonus Offered To Licensed Washington, DC Residents***
WHY ENLIGHTENED? Welcome to Enlightened We provide a work environment that is positive, challenging, and that supports employees' commitment to their communities. As an organization, we are dedicated to continual improvement and growth. We empower all employees to apply their unique background and expertise to serve our clients.
What We're Looking For... A licensed Registered Nurse (RN), or Clinical Social Worker (SW) to serve as a Care Manager to the Bright Start Program supporting the AmeriHealth Caritas DC clinical support team in Washington, DC. The position will assist members appropriate for care coordination and case management services in achieving their optimal level of health.
The ideal candidate will either be an active and licensed RN (nurse) or a Licensed Clinical Social Worker with at least three (3) years of professional practice experience.
***$5000 Hiring Bonus Offered To Licensed Washington, DC Residents***
Responsibilities: The Care Manager (RN) is responsible for engaging the member, member caregiver, and providers to assess, plan and establish individual member goals. The role will facilitate and coordinate care for members throughout the pre and post-partum period while assuring quality and use of cost-effective resources. The position will function as a single point of contact and be an advocate for members throughout their pregnancy.
Education/ Experience: Qualified candidates must reside in the DC Metro area. District of Columbia resident strongly preferred
About the hiring group...As part of the AmeriHealth Caritas DC Clinical Support team, you will be responsible for engaging the member and providers to assess, plan and establish individual member goals.
Benefits We Offer: We provide an industry-competitive benefits package to include:
Enlightened is an equal opportunity employer and does not discriminate on the basis of race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.
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