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Care Manager II, BSN/LICSW (Metro DC area only)
AmeriHealth Caritas • Washington, DC 20080 • Posted 23 days ago
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Hybrid • Full-time • $78,600-$107,100/yr • Mid Level
Job Highlights
Using AI ⚡ to summarize the original job post
The Care Manager II (RN/LICSW) at AmeriHealth Caritas is responsible for assisting members with complex medical needs through care coordination and case management services. This role involves engaging members, their caregivers, and providers to assess, plan, and establish individual member goals, facilitating and coordinating care to ensure quality and cost-effective use of resources. The position operates within a hybrid work environment, requiring onsite work three days a week in Washington, DC.
Responsibilities
- Assess members to determine care coordination and case management needs for all referred members.
- Complete comprehensive person-centered assessment of physical health, psycho-social health, environmental, as well as social determinants of health and supportive needs.
- Identify problems/barriers for care coordination and appropriate care management interventions.
- Coordinate physical, behavioral health and social services.
- Provide medication management, including regular medication reconciliation and support of medication adherence.
- Create a plan of care to assist members in reducing/resolving problems and or barriers so that members may achieve their optimal level of health.
- Identify both short- and long-term goals and associated time frames for completion.
- Identify and implement the appropriate level of intervention based upon the member's needs and clinical progress.
- Schedule follow-up calls as necessary and make appropriate referrals.
- Implement actions to address member issues.
- Document progress towards meeting goals and resolving problems.
- Coordinate care and services with the Care Coordinator, Community Health Navigator, and member, member caregiver as appropriate, PCP, Specialist, and Facility/Vendor Providers.
Qualifications
Required
- Must reside in the DC Metro area
- Active state RN or current unrestricted LICSW license
- Bachelor's degree in a health-related field preferred
- Licensure as a health professional (where such licensure is available) preferred
- Certification as a case manager preferred
- 3 to 5 years of nursing/social work experience required, working with Medicaid populations
- 3 to 5 years' experience working with adult and/or pediatric populations with complex medical and behavioral health needs required
Preferred
- Bilingual English/Spanish or English/Amharic
About AmeriHealth Caritas
AmeriHealth Caritas is a leading managed care organization in the United States, providing Medicaid, Medicare, and CHIP services alongside pharmacy benefit management, behavioral health, and administrative services. The company, established in 1983 to serve Medicaid recipients in Pennsylvania, has since expanded to multiple states, emphasizing comprehensive healthcare solutions for underserved communities. Operating as a subsidiary of Independence Blue Cross, AmeriHealth Caritas focuses on offering high-quality healthcare plans and services to improve the well-being of its members.
Full Job Description
**Care Manager II, BSN/LICSW (Metro DC area only)**
Location: Washington, DC
Primary Job Function: Medical Management
ID**: 34485
**Job Brief**
Current and unrestricted BSN or LICSW in DC. Able to work 3 days at our office located at 445 12th St. SW, Washington, DC, 20024.
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 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 .
**NOTE: AmeriHealth Caritas utilizes a hybrid work environment with associates working from home two days a week and in the office three days a week. The functions of this position will be performed onsite at our offices located at 445 12th St. SW, Washington, DC., 20024.**
**Responsibilities:**
The Care Manager II (Registered Nurse/Licensed Independent Clinical Social Worker) assists members with complex medical needs appropriate for care coordination and case management services in achieving their optimal level of health through self-management. The Care Manager II (RN/LICSW) is responsible for engaging the member, member caregiver, and providers to assess, plan, and establish individual member goals. Will facilitate and coordinate care for the members 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 in the care coordination program.
+ Assess members to determine care coordination and case management needs for all referred members. Works with both adults and children with complex medical needs
+ 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 and 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 caregiver as appropriate, PCP, Specialist, and Facility/Vendor Providers.
**Education/ Experience:**
+ **AmeriHealth Caritas utilizes a hybrid work environment with associates working from home two days a week and in the office three days a week. The functions of this position will be performed onsite at our offices located at 445 12th St. SW, Washington, D.C., 20024.**
+ Qualified candidates must reside in the DC Metro area.
+ Required for RN candidates: Current and unrestricted Registered Nurse licensure in the District of Columbia and a Bachelor's Degree in Nursing.
+ Required for LICSW candidates: Current and unrestricted Licensed Independent Clinical Social Worker (LICSW) licensure in the District of Columbia and a Master's Degree in Social Work.
+ Minimum of 3 years of clinical practice experience as a RN or LICSW working with adults and/or pediatrics with complex medical and behavioral health diagnoses within an acute care, homecare or community health setting.
+ Minimum of years of case management experience supporting Medicaid members within a managed care organization preferred.
+ Must be willing to meet face to face with members in their homes, providers' offices, or in a hospital setting on a monthly basis.
+ Bilingual English/Spanish or English/Amharic preferred.
+ Must have a current Driver's License.
**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 of employment, 401(k) Tuition reimbursement and more.
The range displayed in this job posting reflects the minimum and maximum for new hire salaries for the position in the Washington, DC area.
Within the range, individual pay is determined by additional factors, including, without limitation, job-related skills, experience, and relevant education, certifications, or training.
AmeriHealth Caritas associates are eligible to participate in our annual incentive program and will also receive our benefits package, consisting of medical, vision, dental, life insurance, disability insurance, 401(k), paid time off and more.
The targeted hiring range for this role is expected to be between $78,600 and $107,100.
\#PH
EOE Minorities/Females/Protected Veterans/Disabled
Location: Washington, DC
Primary Job Function: Medical Management
ID**: 34485
**Job Brief**
Current and unrestricted BSN or LICSW in DC. Able to work 3 days at our office located at 445 12th St. SW, Washington, DC, 20024.
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 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 .
**NOTE: AmeriHealth Caritas utilizes a hybrid work environment with associates working from home two days a week and in the office three days a week. The functions of this position will be performed onsite at our offices located at 445 12th St. SW, Washington, DC., 20024.**
**Responsibilities:**
The Care Manager II (Registered Nurse/Licensed Independent Clinical Social Worker) assists members with complex medical needs appropriate for care coordination and case management services in achieving their optimal level of health through self-management. The Care Manager II (RN/LICSW) is responsible for engaging the member, member caregiver, and providers to assess, plan, and establish individual member goals. Will facilitate and coordinate care for the members 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 in the care coordination program.
+ Assess members to determine care coordination and case management needs for all referred members. Works with both adults and children with complex medical needs
+ 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 and 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 caregiver as appropriate, PCP, Specialist, and Facility/Vendor Providers.
**Education/ Experience:**
+ **AmeriHealth Caritas utilizes a hybrid work environment with associates working from home two days a week and in the office three days a week. The functions of this position will be performed onsite at our offices located at 445 12th St. SW, Washington, D.C., 20024.**
+ Qualified candidates must reside in the DC Metro area.
+ Required for RN candidates: Current and unrestricted Registered Nurse licensure in the District of Columbia and a Bachelor's Degree in Nursing.
+ Required for LICSW candidates: Current and unrestricted Licensed Independent Clinical Social Worker (LICSW) licensure in the District of Columbia and a Master's Degree in Social Work.
+ Minimum of 3 years of clinical practice experience as a RN or LICSW working with adults and/or pediatrics with complex medical and behavioral health diagnoses within an acute care, homecare or community health setting.
+ Minimum of years of case management experience supporting Medicaid members within a managed care organization preferred.
+ Must be willing to meet face to face with members in their homes, providers' offices, or in a hospital setting on a monthly basis.
+ Bilingual English/Spanish or English/Amharic preferred.
+ Must have a current Driver's License.
**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 of employment, 401(k) Tuition reimbursement and more.
The range displayed in this job posting reflects the minimum and maximum for new hire salaries for the position in the Washington, DC area.
Within the range, individual pay is determined by additional factors, including, without limitation, job-related skills, experience, and relevant education, certifications, or training.
AmeriHealth Caritas associates are eligible to participate in our annual incentive program and will also receive our benefits package, consisting of medical, vision, dental, life insurance, disability insurance, 401(k), paid time off and more.
The targeted hiring range for this role is expected to be between $78,600 and $107,100.
\#PH
EOE Minorities/Females/Protected Veterans/Disabled
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