Job Abstract

The RN Care Team Manager (RNCTM) contributes to AHF’s mission by displaying the qualities of being knowledgeable, caring and dedicated to HIV/AIDS specialty health plan members. You will lead the care team in:

· ensuring plan members are engaged in their health care,

· collaborating with the member and the PCP to establish and develop health care goals and treatment plans,

· developing personalized care plans which set specific interventions which impact the member’s health & wellbeing,

· achieving mutually agreed upon goals to maximize the member’s best clinical outcomes,

· educating members regarding preventative wellness activities and incentives; and

· acting as the member’s advocate for optimum health outcomes.

By engaging in opportunities to increase knowledge regarding community, government, grant funded programs and health plan resources, the RNCTM can ensure the member is optimizing all available health care resources. You can also assist in improving member focused HEDIS measures, such as preventative wellness, which ensure our members keep healthy or Risk Adjustment which allows us to allocate services to members who are more at risk for poor health outcomes than other members.

Enhance the experience of all Managed Care employees when you collaborate with other departments to ensure member needs are addressed. Improve relations with the AHF Healthcare Centers by integrating in the office and opening lines of communication between the member, health plan, and providers.

Be invaluable to the Care Management team by adapting to various situations with dedication, flexibility and a passion for helping members achieve their personal health goals.