Insurance Case Manager Remote Jobs in Delaware (NOW HIRING)

Qualified candidates must live in and be able to travel throughout Kent County in DE.

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

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, 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:

The Case Manager assists members who are eligible for LTSS in obtaining the services they need as required by Diamond State Health Plan Plus LTSS in Kent county Delaware. He or she contributes to the LTSS case management process by performing telephonic and/or face-to-face assessments for the identification, evaluation, coordination and management of members needs, including physical health, behavioral health, social services and long term services and supports.

• Facilitate person centered planning team meetings to coordinate care and services. Identify, coordinate, and assist members in gaining access to needed LTSS services and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports.
• Provides information to members and conducts monitoring of authorized services and supports for members.
• Informs members about available LTSS required needs assessments, the care plan process, service alternatives and service delivery options.
• Informs members of their rights and responsibilities as well as assists with the complaint, grievance, and DHS Fair Hearing process.
• Collects additional necessary information, including member preferences, strengths, and goals to inform the development of the Plan of Care.
• Conducts comprehensive health needs assessments annually or more frequently as needed in accordance with requirements.

Education:

• High School Diploma required with three (3) years related experience.
• Bachelor's Degree in social work, psychology or other related fields preferred .

Experience:

• At least 3 years working in social service or health care related field.
• Experience working with people with disabilities or seniors in need of LTSS.
• Knowledge of the home and community-based service system and how to access and arrange for services.
• Experience conducting LTSS needs assessments and monitoring LTSS delivery.
• Cultural competency and the ability to provide informed advocacy.
• Ability to interact with health care professionals in a professional manner.
• Ability to travel up to 75% within Kent county
• Qualified candidates must live in and be able to travel throughout New Castle County in DE.

• Valid driver's license required.

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.