Maternity Case Manager

Amerihealth Caritas•Kannapolis, NC

12d•Hybrid

About The Position

The Maternity Care Manager (RN) provides support to pregnant members appropriate for care coordination and case management services in achieving their optimal level of health through self-management. The Maternity Care Manager (RN) is responsible for engaging the member, member caregiver, and providers to assess, plan and establish individual member goals. Will facilitate and coordinate care for the members throughout the pre- and post-partum period while assuring quality and use of cost-effective resources. The position will function as a single point of contact and be an advocate for the members through their pregnancy.

Requirements

Active and unencumbered Registered Nurse license in North Carolina
Qualified candidates must reside within a 30 minute drive of Concord or Kannapolis, North Carolina
Minimum of 3 years of professional practice experience in maternity to include high risk OB and labor and delivery
Willing to meet face to face with members in the community, on occasion, based on their needs.
Valid driver’s license with car insurance.
3+ years of nursing experience required, working with Medicaid populations, either in the hospital or community health setting.

Nice To Haves

3 to 5 years of Case/Care Management experience preferred

Responsibilities

Assess members determine care coordination and care management needs for all referred members.
Provides support to members through their pregnancy and post partum period.
Completes comprehensive person centered assessment inclusive of physical health history, psycho-social health, environmental, as well as, social determinants of health and supportive needs.
Coordinates physical, behavioral health and social services.
Provides medication management, including regular medication reconciliation and support of medication adherence.
Identifies problems/barriers for care coordination and appropriate care management interventions.
Creates a plan of care to assist members in reducing/resolving problems and or barriers so that members may achieve their optimal level of health.
Identifies both short and long-term goals and associated time frames for completion. Shares goals with the member and family as appropriate.
Identifies and implements the appropriate level of intervention based upon the member’s needs and clinical progress.
Schedules follow up calls as necessary, makes appropriate referrals. Implements actions to address member issues. Documents progress towards meeting goals and resolving problems.
Coordinates care and services with the Care Coordinator, Community Health Navigator, and member and member caregiver as appropriate, PCP, Specialist, and Facility/Vendor Providers.