Job Description

Job Brief

Current RN license in PA and BSN req'd. Must reside in Philadelphia or Montgomery counties in PA. Willing to attend community events, as needed.

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nations 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 would like to hear you.

Headquartered in Newtown Square, PA, 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.

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Responsibilities:

The RN Maternity Care Manager II assists pregnant members appropriate for care coordination services in achieving optimal health throughout pregnancy, delivery, and the postpartum period. This position is responsible for engaging the pregnant member and providers to assess, plan and establish individual member goals. The RN Maternity Care Manager II facilitates and coordinates care for pregnant members while assuring quality and use of cost-effective resources. s a single point of contact and be an advocate for pregnant members in the Bright Start Maternity program.

Assesses pregnant members to determine care coordination needs. Completes comprehensive assessment of physical, psychosocial, environmental, and support needs. Identifies problems/barriers and implements actions to address member issues/concerns. Creates a plan of care to assist pregnant 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 family as appropriate and documents progress towards meeting goals and resolving problems. Identifies and implements the appropriate level of intervention based upon the member’s needs and clinical progress. Schedules follow up calls as necessary and makes appropriate referrals. Coordinates care and services with member, family members, OBGYN, PCP, Specialists, and Community Based Organizations as appropriate.

Education/Experience:

• Must reside in Philadelphia or Montgomery counties in Pennsylvania.
• Must be willing to attend community events supporting members enrolled in our maternity program.
• Current and unrestricted Registered Nurse licensure in Pennsylvania required.
• Bachelor's Degree in Nursing required.
• Minimum of 3 years of clinical practice experience Labor and Delivery/Mother-Baby/High Risk Ante-Post Partum.
• Minimum of 3 years of experience as a case manager, preferably providing telephonic case management.
• Case management experience within a managed care organization.
• Certification as a case manager preferred.
• Proficiency using MS Office (Word, Excel, Outlook), internet applications, and electronic medical record and documentation programs.
• Ability to meet deliverables within designated timeframes, strong organization and communication skills.
• Valid driver’s license and car insurance and personal vehicle. 

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

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