Your career starts now. We’re looking for the next generation of healthcare 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 healthcare 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. We'd like to hear from you if you want to make a difference. Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with over 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 Director of Care Management, the Manager of Care Management is responsible for the direct performance of Case Management Responsible for compliance with State and Federal laws and business plan goals.; 1. ;;Plans, organizes and directs the development and implementation of Case Management.; Ensures staff is adequately 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.; 2. ;;Coordinates and implements the development of recommended policies and programs.; Coordinates, establishes, and monitors the achievement of departmental goals and objectives.; Responsible for accomplishing assigned NCQA standard compliance with all applicable state and federal laws and achieving assigned incented health outcomes.; 3. ;;Directs effectiveness of existing programs and services, identifies and evaluates new programs and services to address cost-effectiveness, proposed process improvements, and achieve compliance with NCQA and State incented health outcomes. 4. ;;Participates in and supports the corporate Medical Management Strategy.; 5. ;;Directs the case management activities to comply with the Medicaid Model for case management. ; 6. ; Develop and recommend a consolidated operating budget and submit it to the Director for approval.; Reviews and authorizes disbursement of funds by operating procedures.; Monitors monthly financial statements for areas of responsibility to determine and recommend adjustments. _7._ _;;_ 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. 8. ;;Creates and supports an environment that fosters teamwork, cooperation, respect, and diversity.; Establishes and maintains positive communication and professional demeanor with AMFC employees and providers and liaises with outside entities as required.; Demonstrates and supports commitment to corporate goals and mission. 9.; Performs other duties as assigned. **Education/ Experience:** + Bachelor's Degree required + Active PA (or compact) RN licensure required + 8 to 10 years of progressive experience in healthcare delivery required, with at least;5 years of experience in managed healthcare + Minimum of 5 years managerial experience required; prior manager of case management experience preferred + Minimum of 1 year project management experience required, preferably at the management level + One year of managed Medicaid experience preferred. **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 implement these principles daily 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** Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more. As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.