AmeriHealth Caritas RN Care Manager II--Maternity in New Orleans, Louisiana

RN Care Manager II--Maternity

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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 Philadelphia, 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 .


Description

The Care Manager II will provide utilization & care management to high risk perinatal members. Under the supervision of the Supervisor of Bright Start Perinatal Program, the Care Manager:

  • Facilitates and coordinates care for members while assuring quality, use of cost-effective resources, and monitors appropriate utilization of the member’s benefits
  • Coordinates and performs transition planning for members transitioning between levels of care, and facilitates a smooth transition to home by coordinating with community based agencies, facilities, providers, and practitioners
  • Ensures appropriate follow up with healthcare providers to assist in preventing unnecessary readmissions
  • Completes a comprehensive Initial Assessment and gathers pertinent information about the member’s needs by interviewing the member, appropriate family members, physicians and other members of the Interdisciplinary Care Team
  • Assists high risk pregnant members with appropriate care coordination and case management services to achieve their optimal levels of health
  • Develops, monitors and evaluates the member’s Individualized Care Plan, identifying both short and long term goals and associated time frames for completion
  • Engages members and providers to assess, plan and establish individual member goals, and updates as needed
  • Conducts hospital and face to face member visits as necessary
  • Performs all other duties and projects as assigned

Education/Experience:

  • Clear/Active Louisiana RN licensure required.
  • Minimum one (1) year of OB experience preferred.
  • Minimum one (1) year of Care Manager experience preferred.
  • Eligible for Certification in Case Management within one year of accepting position. Successful attainment of Case Management certification is highly recommended.
  • Valid driver’s license with car insurance

EOE Minorities/Females/Protected Veterans/Disabled