Care Manager (RN/LICSW) Job at Enlightened, Inc. in Washington

Care Manager (RN/LICSW)

WHY ENLIGHTENED? Welcome to Enlightened! We provide a work environment that is positive, challenging, and that supports employees’ commitment to their communities. As an organization, we are dedicated to continual improvement and growth. We empower all employees to apply their unique background and expertise to serve our clients.

What We’re Looking For… A licensed Registered Nurse (RN), or Clinical Social Worker (SW) to serve as a Care Manager to the Bright Start Program supporting the AmeriHealth Caritas DC clinical support team in Washington, DC. The position will assist members appropriate for care coordination and case management services in achieving their optimal level of health.

The ideal candidate will either be an active and licensed RN (nurse) or a Licensed Clinical Social Worker with at least three (3) years of professional practice experience.

Responsibilities: The Care Manager (RN) is responsible for engaging the member, member caregiver, and providers to assess, plan and establish individual member goals. The role will facilitate and coordinate care for members throughout the pre and post-partum period while assuring quality and use of cost-effective resources. The position will function as a single point of contact and be an advocate for members throughout their pregnancy.

• Assess members to determine care coordination and case management needs for all referred members. Works with both adults and children with complex medical needs
• Completes comprehensive person-centered assessment of physical health, psycho-social health, environmental, as well as social determinants of health and supportive needs.
• Identifies problems/barriers for care coordination and appropriate care management interventions.
• Coordinates physical, behavioral health and social services.
• Provides medication management, including regular medication reconciliation and support of medication adherence.
• 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 goals with the member and caregiver 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, makes appropriate referrals. Implements actions to address member issues. Documents progress towards meeting goals and resolving problems.
• Coordinates care and services with the Care Coordinator, Community Health Navigator, and member, member care giver as appropriate, PCP, Specialist, and Facility/Vendor Providers.

Education/ Experience: Qualified candidates must reside in the DC Metro area. District of Columbia resident strongly preferred

Qualified candidates must reside in the DC Metro area

• Active state RN or current unrestricted LICSW license
• A bachelors (or higher) degree in a health-related field preferred and licensure as a health professional (where such licensure is available)
• Certification as a case manager preferred (as documented and accepted on URAC’s website@ www.urac.org)
• 3 to 5 years of nursing/social work experience required, working with Medicaid populations, either in the hospital or community health setting
• 3 to 5 years of experience working with adult and/or pediatric populations with complex medical and behavioral health needs required
• 3 to 5 years of case management experience preferred
• Willing to meet face to face with members in the community based on business needs
• Bilingual English/Spanish or English/Amharic preferred

About the hiring group…As part of the AmeriHealth Caritas DC Clinical Support team, you will be responsible for engaging the member and providers to assess, plan and establish individual member goals.

Benefits We Offer: We provide an industry-competitive benefits package to include:

• Medical/Dental/Vision Insurance w/Health Savings Accounts (HSA)
• Flexible Spending Account(s) (FSA)
• 401(k) Retirement Plan
• Paid Holidays, Vacation, & Sick Leave
• Professional Training & Development Reimbursement

Enlightened is an equal opportunity employer and does not discriminate on the basis of race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.