Care Manager RN--Medicaid HMO occupation at AmeriHealth Mercy Family of Companies in Baton Rouge

AmeriHealth Mercy Family of Companies is currently interviewing Care Manager RN--Medicaid HMO on Fri, 02 Aug 2013 01:33:20 GMT. Under the supervision of the Supervisor ICM, the Care Manager RN assists members appropriate with appropriate care coordination and case management services to achieve their optimal levels of health. The Care Manager is responsible for engaging members and providers to assess, plan and establish individual member goals. The Care Manager will facilitate and coordinate care for members while...

Care Manager RN--Medicaid HMO

Location: Baton Rouge Louisiana

Description: AmeriHealth Mercy Family of Companies is currently interviewing Care Manager RN--Medicaid HMO right now, this occupation will be placed in Louisiana. More complete informations about this occupation opportunity kindly read the description below. Under the supervision of the Supervisor ICM, the Care Manager RN assists members appropriate with appropriate care coordination and case mana! gement services to achieve their optimal levels of health. The Care Manager is responsible for engaging members and providers to assess, plan and establish individual member goals. The Care Manager will facilitate and coordinate care for members while assuring quality and use of cost-effective resources. The Care Manager will function as a single point of contact and be an advocate for members in the care coordination program.

Principal Accountabilities:
Assesses members to determine care coordination and case management needs for all referred members.

Completes comprehensive assessments of environmental, psycho-social and support needs.

Identifies problems/barriers for care coordination and appropriate care management interventions.

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 go! als with members and their families 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 to management.

Implements actions to address member issues.

Documents progress towards meeting goals and resolving problems.

Coordinates care and services with members and family members as appropriate, PCP’s, specialists and facility/vendor providers.

Collaborates with department staff to assist members in receiving quality and cost effective services.

Facilitates access to entitlement programs and/or community resources.

Monitors and documents member’s on going progress.

Conducts hospital and home visits as necessary.

Participates in the discharge planning process for hospitalized members.

Assists members in the transitional process ! from home to a skilled nursing facility for long-term placement.

Arranges for services/appointments.

Participates on project teams as requested.

Maintains confidentiality of all company, provider and member information.

Identifies and refers potential and actual quality issues to quality management staff.

Keeps up-to-date with case management initiatives.

Attends scheduled meetings.

Obtains necessary educational requirements to maintain professional licensure and certifications.

Complies with AMFC and HIPAA confidentiality requirements to protect member personal identifiable health information.

Performs other related duties and projects as assigned.

Adheres to AMFC policies and procedures.

Supports and carries out the Caritas Mission & Values.

Attends required training on an annual basis.

Key Competencies/Success Factors:
Excellent oral and written! communication skills.

Attention to detail.

Ability t! o define problems collects information and recommends solutions.

Knowledge of computer equipment.

Excellent collaboration skills.

Ability to plan and organize.

Ability to promote member/ member family autonomy.

Ability to advocate for member/ member family needs.

Excellent decision-making and follow-up skills.

Self-directed.

Knowledge of community resources as well as plan benefits information.

Ability to analyze clinical outcomes.

Specific clinical knowledge in selected case management area.

Excellent problem solving skills.

Position Qualifications/Requirements: (At least one of the following)

Education and Training:
Associate Degree in Nursing required

Licenses, Registrations or Certification:
Active Louisiana RN license or current.

Valid driver’s license with car insurance

Must be eligible for certi! fication in Case Management within one year of accepting position
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If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to AmeriHealth Mercy Family of Companies.

If you interested on this occupation just click on the Apply button, you will be redirected to the official website

This occupation starts available on: Fri, 02 Aug 2013 01:33:20 GMT

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