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Added 14 mins ago
Care Manager
Amerihealth Caritas
Philadelphia, PA
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities
Added 14 mins ago
Care Manager
Amerihealth Caritas
Philadelphia, PA
Added 11 hours ago
Per Diem Medical Director Utilization Management
Amerihealth Caritas
United States
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities
Added 11 hours ago
Care Manager II
Amerihealth Caritas
Washington, DC
Must reside in the DC metro area
Added 11 hours ago
Service Coordinator-CHC
Amerihealth Caritas
Sunbury, PA
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities
Added 11 hours ago
Corporate Medical Policy Analyst
Amerihealth Caritas
United States
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities
Added 11 hours ago
Service Coordinator-CHC
Amerihealth Caritas
Williamsport, PA
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities
Added 13 hours ago
Dental Director
Amerihealth Caritas
Washington, DC
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities · Must possess an active and unencumbered license to practice dentistry in the District of Columbia
Added 13 hours ago
Coordinator, Disability Advocacy Program (CSHCS)
Amerihealth Caritas
United States
3 to 5 years of managed care experience required
Added 14 hours ago
Market CMO
Amerihealth Caritas
Newtown Square, PA
Monday through Friday, 8:30 AM EST to 5:00 PM EST with 2 to 3 days per week in our office in Harrisburg, PA or Newtown Square, PA · Must hold an active and unencumbered license to practice medicine in Pennsylvania
Added 1 day ago
Regulatory Reporting Specialist Bus
Amerihealth Caritas
United States
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities
Added 1 day ago
Service Coordination Entities Coordinator
Amerihealth Caritas
United States
Qualified candidates must live in the state of Pennsylvania · Valid driver's license required
Added 1 day ago
Vice President Provider Network Management
Amerihealth Caritas
Philadelphia, PA
Added 1 day ago
Manager Provider Network Management
Amerihealth Caritas
Charleston, SC
Minimum of 5 years of provider network management, contracting, reimbursement, or other related experience required · Work Arrangement: Remote: The candidate must reside in South Carolina and possess a valid driver's license
Added 1 day ago
Communications Specialist
Amerihealth Caritas
Southfield, MI
The Associate must reside in Michigan (MI) and be able to attend monthly meeting as needed in Southfield, MI office
Added 1 day ago
Provider Practice Performance Advisor
Amerihealth Caritas
Newark, DE
Added 1 day ago
Account Executive
Amerihealth Caritas
Newark, DE
Added 1 day ago
Coordinator Provider Network
Amerihealth Caritas
Newark, DE
Added 1 day ago
Senior Account Executive
Amerihealth Caritas
Newark, DE
Added 1 day ago
Project Manager III, Infrastructure
Amerihealth Caritas
Newtown Square, PA
Added 1 day ago
Network Contractor Provider Network Management
Amerihealth Caritas
Newark, DE
Added 3 days ago
Utilization Management Technician Sr
Amerihealth Caritas
United States
Added 3 days ago
Clinical Training Consultant
Amerihealth Caritas
United States
Qualified candidates must live in PA, DE, NJ · For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities
Added 4 days ago
Member Services Specialist
Amerihealth Caritas
Robbinsville, NJ
Work Arrangement: Remote - DE, NJ, NY, PA must live within 3 hours of Robbinsville NJ
Added 4 days ago
Community Health Navigator
Amerihealth Caritas
Reading, PA
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities

Amerihealth Caritas

Care Manager

Philadelphia, PA, United States

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Job details

Experience: Minimum of 3 to 5 years experience with the physical health population required. 2.
Posting language: English
Posted: Oct 20, 2026

Original job description

The Care Manager (RN)assists members appropriate for care management and care coordination services in achieving their optimal level of health through self-management. The Care Manager (RN) engages members, member caregivers, and providers to assess, plan, and establish individual member goals. Will facilitate and coordinate care for the members 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 in the care coordination program. In addition, the Care Manager will oversee these same care management activities within assigned practices to ensure the ACPA delivers high-quality care management services following Plan, NCQA, Federal/State standards and requirements. Work Arrangement: Fully Remote; must be able to Monday-Friday 8:30am-5:00pm Eastern Time Zone Responsibilities: 1. Assess members through face-to-face encounters and by telephone to determine care coordination and care management needs for all referred members. 2. Completes comprehensive person-centered assessment, inclusive of physical health history, mental health history, social determinants of health, and supportive needs 3. Coordinates physical, behavioral health, and social services. 4. Provides medication management, including regular medication reconciliation and support of medication adherence. 5. Identifies problems/barriers for care coordination and appropriate care management interventions. 6. 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 goals and assigns priority with associated time frames for completion. Shares goals with the member and family as appropriate. 7. Identifies and implements the appropriate level of intervention based upon the member's needs and clinical progress. 8. Schedules follow-up calls as necessary and makes appropriate referrals. Implements actions to address member issues. 9. Documents progress towards meeting goals and resolving problems within EMR system. 10. Coordinates care and services with the Community Health Navigator and member, member caregiver as appropriate, PCP, Specialist, and Facility/Vendor Providers. 11. Provides transitional care management. Meets regularly with designated partners regarding plan-identified members for care management, assists with reducing/resolving problems and or barriers so that the ACDE Care Coordinator may provide members with high-quality care management services. 12. Participate in regularly scheduled meetings as needed. Education/Experience: 1. Minimum of 3 to 5 years experience with the physical health population required. 2. Experience working with individuals with Medicaid and Medicare populations preferred 3. Ability to work with specific care teams and other engagement community partners preferred. 4. Case management experience, preferably within a managed care organization, is desired. 5. Proficient with various technologies including Microsoft Tools and Medical Record systems. 6. Bilingual (Spanish speaking) preferred Licensure: 1. Current, unrestricted Pennsylvania or Compact RN license in good standing with experience in managing medical complexities. Skills & Abilities: 1. Demonstrate ability to be self-directed, independent, adaptive, flexible to change, and able to collaborate as a team member in a fast-paced, ever-changing environment. 2. Demonstrate awareness, attitude, knowledge, and skills needed to work effectively with a culturally and demographically diverse population. 3. Proficiency using MS Office (Word, Excel, Outlook, Teams), internet applications, and electronic medical record and documentation programs. 4. Demonstrate strong organizational and time management skills with the ability to promptly prioritize and follow through on multiple items. 5. Demonstrate knowledge and e perience in assessing members' situations, developing a care plan, and teaching self-management 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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More about this job

Skills

Coordinate care
EMR
Paramedic
Case management
Microsoft Office
Microsoft Word
Microsoft Excel
Microsoft Outlook
Microsoft Teams
Time management

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