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Community Care Manager

AmeriHealth Caritas

Southfield, MI

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JOB DETAILS
SKILLS
Accreditation Standards, Auto Insurance, Behavioral Health, Case Management, Clinical Competency, Coaching, Communication Skills, Community Programs, Community Relations, Community Support, Community and Social Services, Disease Prevention and Control, Diversity, Documentation, Driver's License, Environmental Impact, Health Plan, Healthcare, Interpersonal Skills, Medications, Microsoft Office, Needs Assessment, Nursing, Operations Management, Organizational Skills, People Management, Problem Solving Skills, Reconciliation, Registered Nurse (RN), Regulations, Regulatory Compliance, Risk Analysis, Social Work, Systems Administration/Management, Team Player, Time Management, Willing to Travel
LOCATION
Southfield, MI
POSTED
9 days ago
Role Overview: The Community Care Manager assists members appropriate for care coordination and case management program services in a community setting.


Work Arrangements:


+ Remote – Associate must reside in the state of Michigan (MI); preferred counties include Wayne, Oakland, and Macomb.

+ Must be able to travel to conduct home visits.


Responsibilities:


+ Serves as a single point of contact for member questions and inquiries

+ Conducts in-home environmental and physical assessments for high-risk members to identify unmet needs and barriers to care

+ Develops and maintains individualized care plans, ensuring they are regularly reviewed and updated

+ Provides disease self-management education and coaching within scope of practice

+ Performs medication reviews, including reconciliation during transitions of care

+ Ensures care is delivered in the least restrictive setting and supports transitions across specialties and care settings

+ Connects members to community-based resources that promote independent living and help delay or prevent nursing facility placement

+ Establishes and maintains collaborative relationships with community, medical, and behavioral health teams

+ Works closely with and oversees Community Care Connectors to facilitate access to appropriate in-community services

+ Serves as a program subject matter expert and supports the Community Care Program Manager with operational activities as needed


Education & Experience:


+ Bachelor’s degree in nursing or social work required.

+ Current, active, and unrestricted Registered Nurse (RN) or Licensed Master Social Worker (LMSW)

+ 3 years of experience conducting health assessments and delivering care in a clinical and community environment


Licensure:


+ Current, active, and unrestricted Registered Nurse (RN) or Licensed Master Social Worker (LMSW)

+ Valid driver’s license with car insurance.


Skills & Abilities:


+ Strong clinical assessment skills with the ability to evaluate member needs and identify barriers to care

+ Strong communication and interpersonal skills, with the ability to engage members and collaborate with interdisciplinary teams

+ Ability to educate and coach members on disease management and self-care strategies

+ Critical thinking and problem-solving skills to address complex member needs and resolve care issues

+ Strong organizational and time management skills

+ Ability to collaborate with and provide guidance to team members

+ Knowledge of healthcare regulations, accreditation standards, and compliance

+ Proficiency with documentation systems, care management platforms, and Microsoft Office tools
As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

About the Company

A

AmeriHealth Caritas

Leaders in health care solutions for those most in need

AmeriHealth Caritas is the nation's leader in providing comprehensive health care solutions for those in most need and the chronically ill. We impact the lives of more than 5.7 million members nationwide. With more than 30 years of experience managing care for individuals and families in publicly-funded programs, we have become known for developing innovative solutions that help improve health outcomes while reducing costs.

Our mission, our goal

Our mission is to help people get care, stay well and build healthy communities. Our goal is to provide responsible managed care solutions, including Medicaid, Medicare, and CHIP - plus behavioral health, pharmacy benefits management and third-party management and administrative services.

COMPANY SIZE
5,000 to 9,999 employees
INDUSTRY
Healthcare Services
FOUNDED
1985
WEBSITE
http://www.amerihealthcaritas.com