Maternity Case Manager - Remote Eligible

Maternity Care Manager

Role Overview: The Maternity Care Manager plays a vital role in supporting pregnant members by providing personalized care coordination and case management services. This position focuses on helping members achieve their best possible health outcomes through education, advocacy, and self-management. As a single point of contact, the Care Manager collaborates with members, their caregivers, and healthcare providers to assess needs, develop individualized care plans, and establish achievable health goals. They guide and support members throughout the prenatal and postpartum periods, ensuring access to high-quality, cost-effective resources while promoting continuity of care and a positive pregnancy experience.

Work Arrangement: Remote - The associate can work remotely anywhere within New Hampshire, with occasional travel required for the role.

Responsibilities:

• Assess members to determine care coordination and case management needs for all referred members. Provides support to members throughout their pregnancy and postpartum period.
• Completes a comprehensive person-centered assessment that includes physical health, psycho-social health, environmental, as well as social determinants of health, and supportive needs
• Identifies problems/barriers for care coordination and appropriate care management interventions.
• Provides medication management, including regular medication reconciliation and support of medication adherence.
• 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 caregiver appropriate.
• Identifies and implements the appropriate level of intervention based upon the member's needs and clinical progress.
• Schedules follow-up calls as necessary and makes appropriate referrals.
• Implement actions to address member issues.
• Documents progress towards meeting goals and resolving problems.
• Coordinates care and services with the Care Coordinator, Community Health Navigator, member, member's caregiver as appropriate, PCP, Specialist, and Facility / Vendor Providers.

Education & Experience:

• Bachelor's degree in Nursing required
• 3 to 5 years of experience in case management, preferably in a telephonic setting
• Minimum of 3 years of experience in maternity or pediatric care
• Certified Case Manager (CCM) certification preferred
• Proficient in Microsoft Office, internet applications, electronic medical records, and documentation systems

Licensure:

• Current and unrestricted Registered Nurse (RN) licensure or current unrestricted Social Worker License in New Hampshire.
• Valid driver's license and car insurance.

Skills & Abilities:

• Ability to meet deliverables within designated timeframes.
• Strong organization and communication skills.