Transition Care Manager
- AmeriHealth Caritas
- | Anywhere, CT
$55,241 per year |
OTHER |
May 7th, 2025
-
AmeriHealth Caritas -
Anywhere, CT
-
$55,241 per year
-
OTHER
-
May 7th, 2025
Your career starts now. Were looking for the next generation of health care leaders.
At AmeriHealth Caritas, were passionate about helping people get care, stay well and build healthy communities. As one of the nations 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, wed 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
This position is a remote position with a strong preference of a South Carolina resident. ;Behavioral Health background preferred. ; Hours are 10-7 Eastern ;Monday - Friday. ;
Responsibilities:
Under the Direction of the Supervisor, the Transition Care Manager is responsible for completing preventative multidisciplinary discharge planning for plan member presenting to the Emergency Room and / or Acute Setting using AmeriHealth Caritas policies and procedures. ;The Transition Care Manager will assess and processes discharge planning needs across all disciplines including necessary case management referrals. ;;
This position may include the following responsibilities: consistent application of medical health benefit policy and medical management guidelines to authorize services, appropriately identifies and refers requests to the Medical Director when guidelines are not met, review of daily ER or inpatient census of plan members, receive and process facility referrals, face to face interaction with plan members, complete survey to identify plan member needs, identify gaps in care, determine members understanding of illness and outpatient management of illness in addition to evaluating and coordinating and implementing discharge needs for all short and long term needs across disciplines including but not limited to PCP, home care, skilled nursing and rehabilitation services, DME, pharmacy, case management and/ or social worker referral for community needs and availability, scheduling appointments and arranging critical follow-up calls for care coordination, and member education on how and where to seek appropriate care and follow-up services.
Education/Experience:
- Registered Nurse, or fully licensed Social Worker required. ;
- Minimum of 3 years nursing experience, in related clinical setting.
- Managed care experience required.
- Emergency Room or Acute Discharge Planning Experience preferred. ; Strong Behavioral Health background strongly preferred. ;
- Proficiency with Microsoft Office Suite (Word, Excel, Power Point). Access is a plus.
- Consistent word processing speed and accuracy of 50 or more words per minute.
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, 401(k) Tuition reimbursement and more.
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