AmeriHealth Caritas Case Manager, DSHP in Newark, Delaware

Case Manager, DSHP

Location: Newark, DE

Telecommuter?: Yes

ID**: 14280

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 atwww.amerihealthcaritas.com.

Responsibilities:

The Case Manager assists members who are eligible for LTSS in obtaining the services they need as required by DSHP Plus LTSS. He or she contributes to the LTSS case management process by performing telephonic and/or face-to-face assessments for the identification, evaluation, coordination and management of member’s needs, including physical health, behavioral health, social services and long term services and supports.

Key Accountabilities and Responsibilities

  • Facilitate person centered planning team meetings to coordinate care and services. Identify, coordinate, and assist members in gaining access to needed LTSS services and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports.

  • Provides information to members and conducts monitoring of authorized services and supports for Members.

  • Informs members about available LTSS required needs assessments, the care plan process, service alternatives and service delivery options.

  • Informs members of their rights and responsibilities as well as assists with the complaint, grievance, and DHS Fair Hearing process.

  • Collects additional necessary information, including member preferences, strengths, and goals to inform the development of the Plan of Care.

  • Conducts comprehensive health needs assessments annually or more frequently as needed in accordance with requirements.

Education/Experience:

  • A minimum of three years working in social service or health care related field

  • Experience working with people with disabilities or seniors in need of LTSS

  • Knowledge of the home and community-based service system and how to access and arrange for services;

  • Experience conducting LTSS needs assessments and monitoring LTSS delivery.

  • Cultural competency and the ability to provide informed advocacy;

  • Ability to interact with health care professionals in a professional manner.

  • Valid Drivers license and the ability to travel up to 75%

  • Bachelors degree in social work, psychology or related field

EOE Minorities/Females/Protected Veterans/Disabled