Job Description

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 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 would like to connect with you.

Headquartered in Newtown Square, 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.

Responsibilities:

• Under the supervision of the Market Clinical Director, Population Health, the Manager of Integrated Case Management (ICM) is responsible for the daily operations of the Bright Start (Maternity) and Early Intervention ICM teams. Responsible for compliance with State and Federal laws and business plan goals.
• Plans, organizes and directs the development and implementation of Case Management of our maternity and children with special needs populations in DC. Ensures staff is properly trained, oriented and provided with regular professional development. Identifies opportunities for improvement, both clinical and administrative, and assists the Director in the strategic planning processes for these functions.
• 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.
• Directs effectiveness of existing programs and services identifies and evaluates new programs and services to address cost effectiveness, proposed process improvements and to achieve compliance with NCQA and State incented health outcomes.
• Participates in and supports the corporate Population Health strategy.
• Develops and recommends a consolidated operating budget and submits to Director for approval. Reviews and authorizes disbursement of funds in accordance with operating procedures. Monitors monthly financial statements for areas of responsibility to determine and recommend adjustments.
• Directs 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 ACFC associates, 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/ Experience:

• The selected candidate will have a hybrid work schedule working 3 days a week at our AmeriHealth DC office located at 445 12th Street SW.
• Bachelor's Degree required; Bachelor’s Degree in Nursing (BSN) preferred.
• Current and unrestricted Registered Nurse licensure in the District of Columbia required.
• Minimum of 5 years clinical practice experience in the maternal/child health space.
• Minimum of 5 years progressive leadership experience in maternal/child health required. Experience serving Medicaid populations or working within a community/public healthcare setting managing programs and overseeing teams.
• Minimum of 2 years of experience in managed health care preferred.
• Minimum of 5 years of managerial experience required.
• Minimum of 1 year of project management experience preferred, preferably at management level.
• Proficiency in MS Office (Word, Excel, Outlook, Teams) in a Windows based environment, internet applications, and electronic medical record and documentation programs.

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

The range displayed in this job posting reflects the minimum and maximum for new hire salaries for the position in the District of Columbia area.
Within the range, individual pay is determined by additional factors, including, without limitation, job-related skills, experience, and relevant education, certifications, or training.
AmeriHealth Caritas associates are eligible to participate in our annual incentive program and will also receive our benefits package, consisting of medical, vision, dental, life insurance, disability insurance, 401(k), paid time off and more.
The targeted hiring range for this role is expected to be between $100,800.00 and $137,500.00.

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