Maternal Care Management Coordinator, RN

About the role

The Maternal Care Management Coordinator works with high-risk pregnant Members to provide individualized, expert clinical support, helping them navigate the complexities of their prenatal, antenatal, and postpartum journey. The incumbent conducts thorough clinical and behavioral assessments to understand the Member’s health status, disease progression, and treatment plan, identifying issues that could impact care. Using a multi-disciplinary approach, the coordinator collaborates with Providers and Members on discharge planning, treatment plans, Member education, and care coordination to ensure quality, cost-effective maternal and infant outcomes.

The role serves as a point of contact and Member advocate, identifying gaps in care and eliminating barriers to timely, best-practice-supported care. The coordinator determines medical necessity for hospital, outpatient, or home services based on evidence-based guidelines and participates in Care Conferences to facilitate multi-disciplinary reviews of high-risk cases. The incumbent stays current with best practice guidelines for maternal and infant health, aligning care coordination efforts with the Company’s value-based quality initiatives.

The Maternal Care Management Coordinator functions within a broader internal multidisciplinary health management team, including clinical pharmacists, health and wellness coaches, Medical Directors, and others.

Requirements

• Bachelor’s degree in Nursing and unrestricted RN licensure in the state of Mississippi
• At least three years of recent maternal health clinical experience
• Certified Case Manager (CCM®) certification preferred; must obtain within 2 years of hire if not certified upon hire
• Excellent clinical thinking and oral/written communication skills
• Strong organizational skills to prioritize tasks and meet deadlines
• Ability to work a flexible schedule when required
• Above-average PC skills and intermediate knowledge of Microsoft Office

Benefits

We offer a comprehensive benefits package worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field.