Your career starts now. We’re looking for the next generation of health care leaders.
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 #removed#.
Under the supervision of the Manager, Population Health/Care Management, the Supervisor is responsible for the daily oversight of the Care Management activities providing clinical direction, organization, and monitoring of all care management services. Responsible for direct supervisory oversight of staff conducting care management screening, care coordination, care management and other supportive functions. Assists in carrying out the plans and daily operations of the Care Management activities. Provides regional and departmental leadership.
This position will cover Region 2
- Assists with planning, organizing and directing the implementation of Care Management. Ensures staff is properly trained, oriented and provided with regular professional development. Identifies opportunities for improvement, both clinical and administrative, and assists the Manager in the strategic planning processes for these functions.
- In conjunction with Manager, coordinates and implements the development of recommended policies and programs. Coordinates, establishes and monitors achievement of departmental goals and objectives. Responsible for achievement of assigned NCQA standard compliance and compliance with all applicable State and Federal laws, as well as achievement of assigned incented health outcomes.
- Ensures effectiveness of existing programs and services, identifies and evaluates new programs and services to address cost effectiveness through improving patient care and health outcomes while reducing inappropriate hospitalizations and other unnecessary costs, proposed process improvements and to achieve compliance with NCQA and State incented health outcomes.
- Supervises and manages a team of Delegation Oversight Coordinators.
- Assists with the account management, oversight and performance monitoring of ongoing subcontractor/vendor partnerships. Responsible for the identification, development, communication and management of performance improvement activities related to subcontractor/vendor services or operational processes.
- Participates in and supports the corporate Population Health Strategy.
- Ensures the coordination of positive inter and intra communication to share information regarding quality of care, member issues and cost effective services. Works across departmental lines to achieve objectives.
- Creates and supports an environment that fosters teamwork, cooperation, respect and diversity. Establishes and maintains positive communication and professional demeanor with AMFC employees, providers and acts as liaison with outside entities as required. Demonstrates and supports commitment to corporate goals and mission.
- Performs other related duties and projects as assigned.
Education and Experience:
- Supervisory experience in a healthcare setting.
- Clinical practice experience and must be able to practice care management within the scope of the licensure based on the standards of the discipline.
- Bachelor’s Degree in nursing preferred.
- An unrestricted RN license to practice nursing in North Carolina.
- Excellent organizational, analytical and interpersonal skills required.
- Excellent written and verbal communication skills.
- Excellent decision making and problem solving skills.
- Proficient PC skills in a windows based environment.
This position will provide coverage for regions 2. Must live within the region which is Greensboro and surrounding counties.