Geriatric care manager job description

Primary Job Function: Medical Management

ID**: 24975

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 at www.amerihealthcaritas.com .

**Responsibilities:**

Under the Supervision of the Manager of Care Management, the Care Manager is responsible for the overall accountability for the identification of members appropriate for care management services. Completes a comprehensive Initial Assessment and gathers pertinent information about the member's needs by interviewing the member or making home/facility visits, appropriate family members, physicians and other members of the Interdisciplinary Care Team to develop, monitor and evaluate the member's Individualized Care Plan and update as needed. Serve as an advocate for the member and acts as a liaison between the member and other community based agencies, facilities, providers, and practitioners in coordinating the member's care. Coordinates and performs transition planning for members transitioning between levels of care. Monitors appropriate utilization of the member's benefits and coordinates services with other payer sources. Perform all other duties and projects as assigned.

**Education/ Experience:**

+ Bachelor's Degree Desirable but not required.

+ Master's Degree/SW.

+ LSW(Licensed social worker).

+ Registered Nurse.

+ 1 to 3 years Care Management experience; must have relevant experience/education to work with members with complex health, behavioral health, and sup ports and/or psychosocial needs.

EOE Minorities/Females/Protected Veterans/Disabled

• Bachelor’s Degree in gerontology, health care, social work or related profession from an accredited university; relevant professional experience may substitute.

• Case Management Certification preferred (CMC) or (CCM)

• 5 year’s Case Management experience in a multidisciplinary clinical setting (i.e., hospital, insurance company, case management organization).

• Strong written and verbal communication skills.

• Ability to prioritize, plan, flex and manage a very busy work environment.

• Current driver’s license and proof of insurance; ability to travel within the field.

• Flexibility and adaptability to thrive in a fast-paced environment in which change is the norm.

• An entrepreneurial spirit, drive, and goal-oriented work ethic.

• High energy and a positive attitude, with the ability to excel under pressure.

Leadership Competencies:

• Emotional Intelligence – namely, self-aware, self-management, motivation, empathy, integrity, social skills, and well-placed boundaries

• Strong and meaningful relationship building skills and communication abilities

• The ability to navigate through various stressors and challenges

• Humility and authenticity

• Organizational agility – innovative and responsive

• The ability to partner with others to create trust, rapport, and respect

• Sense of community

• Compassion

Success Factors
To excel in this role, you will be passionate about helping clients achieve successful long-term aging at home by providing comprehensive, concierge-based care. The ideal candidate for this position has deep emotional intelligence and a personal commitment to always doing the right thing. It’s also important to touch on the nature of the home healthcare world. We are in the business of helping others and sometimes crisis situations occur after-hours. We’ll need you to be responsive and able to act with a sense of urgency. We’re proud of our ego-less culture where we all work for the common good. At the end of the day, we’re taking care of our senior community, to truly find success here you’ll need to be passionate about our cause and compassionate for the work we do day in and day out.

EOE

Organization:

SPMF-Sutter Pacific Medical Foundation - South

Position Overview:

Manages and provides operational leadership to assigned areas of the Medical Foundation/ Outpatient Clinics ensuring that they meeting the organizational goals and initiatives of patient and team safety, affordability, quality, patient satisfaction and access. Plans and organizes operations and resources to ensure effective and efficient delivery of patient care consistent with applicable laws, standards and regulations. Establishes protocols and practices, ensuring compliance with department, affiliate, operating unit, and/or system standards, policies and procedures, local and state standards, and applicable laws and regulations. Takes a strategic and tactical approach in identifying best practices and standardizing workflows/processes, and developing plans of action to implement changes. Establishes and manages capital and operational budgets to achieve financial targets via effective utilization of personnel, resources and supplies. Develops and maintains a solid partnership with internal and external peers, leaders, and/or local/state/federal agencies to facilitate and collaborate on initiatives or issues resolution. Provides guidance and/or direct intervention in resolving challenging or complex situations.

Job Description:

EDUCATION

Equivalent experience will be accepted in lieu of the required degree or diploma.

Bachelor's: Business Administration, Healthcare or related field or equivalent education/experience

PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN:

* 8 years supervisory or management experience in ambulatory healthcare setting.
* 8 years experience in professional discipline with increasing responsibilities.
* 8 years experience of budgeting and fiscal management.

SKILLS AND KNOWLEDGE

* Extensive knowledge of healthcare operations in a non-acute setting and how department's process/workflow impacts other department operations.
* A comprehensive knowledge of all applicable State, federal, state licensing and other local regulations as they relate to Outpatient Services is required, including but not limited to Medicare, MediCal, Medicaid, Knox Keene Act and the Starke II Statute.
* An background and ability to form relations with physicians and medical directors as well as with nursing, and other key departments.
* Demonstrated leadership skills, including team building, and coaching/mentoring with the ability to motivate and engage others.
* Thorough understanding of operations and workflows and how.
* Demonstrates tactical and analytical thinking and planning skills, and is able to develop plan to accomplish objectives, identify obstacles and resolve operational issues.
* Ability to build and establish effective working partnership with employees, peers, physicians and/or leaders to achieve business objectives.
* Verbal and written communication, and interpersonal skills.
* Ability to handle difficult circumstances and make sound business decisions with little direction.
* Demonstrates ability to work in a dynamic and fast-paced environment with changing business priorities.
* Organizational and time management skills, with the ability to prioritize multiple projects while delivering quality service and achieving business results.
* Demonstrates a customer service focus in all decisions and actions.
* Demonstrates ability to work/interact with a diverse population while respecting cultural and linguistic differences and fostering an inclusive work environment.
* Working knowledge of wage and hour laws.

Job Shift:

Days

Schedule:

Full Time

Shift Hours:

8

Days of the Week:

Friday, Monday, Thursday, Tuesday, Wednesday

Weekend Requirements:

None

Benefits:

Yes

Unions:

No

Position Status:

Exempt

Weekly Hours:

40

Employee Status:

Regular

Number of Openings:

1

Sutter Health Affiliates are equal opportunity employers EOE/M/F/Disability/Veterans.