Unclassified-posted about 1 year ago
$83,200 - $83,200/Yr
Full-time • Mid Level
Remote

The Registered Nurse Obstetrics Case Manager plays a crucial role in managing care for members with complex and chronic needs within a large state-run managed care program. This position primarily operates remotely but requires travel for in-person meetings and assessments, particularly in obstetrics settings. The role involves assessing, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize member health care across the care continuum.

  • Ensures member access to services appropriate to their health needs.
  • Conducts assessments to identify individual needs and develops a specific care management plan.
  • Implements care plans by facilitating authorizations/referrals as appropriate.
  • Coordinates internal and external resources to meet identified needs.
  • Monitors and evaluates the effectiveness of the care management plan and modifies as necessary.
  • Interfaces with Medical Directors and Physician Advisors on care management treatment plans.
  • Negotiates rates of reimbursement, as applicable.
  • Assists in problem-solving with providers, claims, or service issues.
  • Current, active unrestricted RN license in the state of Indiana.
  • BA/BS in a health-related field and minimum of 3 years of clinical experience, or equivalent education and experience.
  • OB nursing experience is strongly preferred.
  • Case management experience.
  • Previous managed care experience preferred.
  • Discharge planning experience.
  • Substance Use Experience is preferred.
  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance
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