AmeriHealth Caritas Director, Integrated Care Management RN in Newark, Delaware

Director, Integrated Care Management RN

Location: Newark, DE

Telecommuter?: No

ID**: 14271

Job Brief

Leadership, direction and strategic vision for the Integrated Care Management

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:

This position is responsible for the leadership, direction and strategic vision for the Integrated Care Management processes for the Plan to include case management services for all DSHP and DSHP Plus Members. Responsible for the design, development, implementation and ongoing improvement of health outcomes outreach and education. Responsible for assuring compliance with State and Federal regulations, contractual obligations and NCQA requirements. Integrated Care Management includes the focused care management areas of (including but not limited to) Special Needs, Maternal Care, Complex integrated care management and Pediatric Shift Care. Will lead staff efforts to contribute to EPSDT and HEDIS measures

Job Related Skills and Experience:

  • BSN and current, unrestricted RN licensure in state of Delaware

  • 3 to 5 years management experience within a Case Management Department, preferably within managed care

  • 5 to 10 years experience of progressive healthcare experience.

  • Excellent organizational, analytical and interpersonal skills required.

  • Ability to develop, design and implement programs to address cost efficient and quality medical care.

  • Ability to develop and maintain operational budget.

  • Excellent written and verbal communication skills.

  • Proficient PC skills in a windows based environment.

EOE Minorities/Females/Protected Veterans/Disabled