Maternal Care Management Coordinator, RN
About the role
The Maternal Care Management Coordinator is responsible for providing individualized, expert clinical support to high-risk pregnant Members, navigating their prenatal, antenatal, and postpartum journeys. This role involves conducting thorough clinical and behavioral assessments, working with the Provider and Member through a multi-disciplinary approach, facilitating appropriate treatment plans, educating Members, and coordinating care needs to achieve desired outcomes.
Responsibilities
- Conduct thorough clinical and behavioral assessments to understand Member's health status, disease states, and treatment plans.
- Work with the Provider and Member through a multi-disciplinary approach, including discharge planning, treatment plan facilitation, Member education, and coordination of care needs.
- Function within a broader internal multidisciplinary health management team, collaborating with clinical pharmacists, health and wellness coaches, and the Medical Director.
- Serve as a point of contact and Member advocate, identifying gaps in care and eliminating barriers to timely, best practice-supported care.
- Determine if hospital, outpatient, or home services are medically necessary and supported by evidence-based, best practice guidelines.
- Participate in Care Conferences with the clinical teams to facilitate appropriate action plans and referrals for Quality Management review if applicable.
- Stay updated with evidence-based best practice guidelines for maternal and infant health and align care coordination efforts with the Company’s value-based quality initiatives.
Requirements
- Bachelor’s degree in Nursing and RN licensure that is unrestricted in the state of Mississippi required.
- At least three years of recent maternal health clinical experience is required.
- Certified Case Manager (CCM®) certification preferred, to be obtained within 2 years of hire if not certified upon hire.
- Excellent clinical thinking and communication skills are required.
- Strong organizational skills to prioritize tasks and meet deadlines.
- Able to work a flexible schedule when required.
- Advanced PC skills and intermediate knowledge of Microsoft Office.
Qualifications
Must have excellent clinical thinking skills and excellent oral/written communication skills.
Skills
Knowledge of evidence-based best practice guidelines for maternal and infant health.
Benefits
Comprehensive benefits package worth approximately one-third of the salary compensation.
Pay
Details on pay are not specified in the job posting.
Schedule
Details on the schedule are not specified in the job posting.