AmeriHealth Caritas - Aiken, SC
posted 23 days ago
Full-time - Entry Level
Remote - Aiken, SC
Insurance Carriers and Related Activities
About the position
The Field-Based Remote Behavioral Health Case Worker at AmeriHealth Caritas is responsible for managing and coordinating care for members with behavioral health conditions and complex needs. This role serves as the primary contact for the care team, guiding members towards optimal health through assessment, planning, and collaboration with healthcare providers and community resources. The position emphasizes strong communication, critical thinking, and clinical skills to address barriers to care and promote self-management among members.
Responsibilities
- Manage and coordinate care for members with behavioral health conditions and complex needs.
- Serve as the primary point of contact for the care team, including members, physicians, and community supports.
- Utilize assessment and communication skills to identify issues and gaps in care.
- Develop a plan of care through shared decision-making with members and caregivers.
- Support members during transitions of care, including education and referrals.
- Review medication lists and coordinate pharmacy needs with community pharmacists.
- Evaluate and update care plans based on member progress and preferences.
- Establish collaboration points with community, medical, and behavioral health teams.
- Maintain accurate documentation of member interactions in electronic care management platforms.
- Monitor service utilization and coordinate with other payer sources.
- Identify cases for care management rounds and follow up with providers on recommendations.
- Conduct face-to-face visits for education and assessment at various locations.
Requirements
- Bachelor's Degree in Human Services or related field; Master's degree preferred.
- 2 years of professional experience working with members with Serious Mental Illness (SMI).
- 2 years of social services experience engaging with clients and assessing their needs.
- Proficiency in MS Office and electronic medical record/documentation programs.
- Experience with Electronic Case Management Platforms (e.g., Jiva).
- Ability to manage a caseload of up to 60 members.
- Strong documentation and record-keeping skills.
- Proven expertise in assessing situations and developing care plans.
- Skilled in effective communication and health education.
Nice-to-haves
- Experience in behavioral health settings.
- Knowledge of community resources and programs.
- Familiarity with NCQA requirements.
Benefits
- 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
- Comprehensive benefits package
