Role Overview
The Bright Start Care Coordination Manager II (RN) plays a vital role in guiding members towards achieving their highest level of health. This position involves actively engaging with members and healthcare providers to assess, plan, and establish individualized health goals. You will coordinate care to ensure quality services while utilizing cost-effective resources. As a single point of contact, you will advocate for members within the care coordination program.
Key Responsibilities
- Assess and identify the care coordination and case management needs for members.
- Perform comprehensive evaluations of members' environmental, psychosocial, and support needs.
- Recognize barriers to care and implement effective management interventions.
- Develop personalized care plans aimed at helping members overcome challenges and achieve optimal health.
- Define both short-term and long-term goals with associated timelines for completion.
- Communicate goals clearly with members and their families as appropriate.
- Select and implement interventions tailored to the member's needs and progress.
- Schedule necessary follow-up calls and make appropriate referrals.
- Document progress towards goals and resolution of issues.
- Coordinate care with the Complex RN Case Manager, the member, family members, and relevant healthcare providers.
Experience Required
- Able to conduct face-to-face visits with members based on business needs.
- Minimum of 3 years of clinical practice experience in obstetrics, focusing on prenatal and postpartum care.
- At least 1 year of case management experience, whether in a hospital, homecare, or remote setting.
- Prior case management experience in a managed care setting (Medicaid/Medicare) is preferred.
- Certification as a case manager preferred.
- Bilingual proficiency in Spanish is a plus.
- Strong organizational and communication skills; ability to meet deadlines.
- Proficient in Windows 10, MS Office, and electronic medical record documentation.
- Must have a personal vehicle, valid driver's license, and car insurance.
Education Requirements
- Graduate from an accredited nursing school; Associate's Degree in Nursing required, Bachelor's Degree preferred.
- Current and unrestricted Registered Nurse license in Louisiana or multi-state compact licensure required.
Your career can begin today! We seek passionate individuals who are committed to making a difference in health care. At AmeriHealth Caritas, we believe in helping individuals gain access to care, maintain wellness, and develop healthy communities. Join us as we empower millions through our diverse programs and services.
Located in Newtown Square, AmeriHealth Caritas is a proud mission-driven organization with over 30 years of experience delivering essential care. We provide a wide range of services including managed care products, pharmaceutical benefits, behavioral health services, and more.
Comprehensive Benefits Package
We offer flexible work solutions, competitive pay, paid time off including holidays and volunteer events, healthcare coverage for you and your family starting on Day 1, a solid 401(k) plan, tuition reimbursement, and other great benefits.