RN Maternity Care Manager II (Philadelphia and Montgomery Counties in PA) at AmeriHealth Caritas

Unclassified - Philadelphia, PA

Full-time - Mid Level

Remote - Philadelphia, PA

About the position

The RN Maternity Care Manager II plays a crucial role in supporting pregnant members throughout their pregnancy journey, from prenatal care to postpartum recovery. This position is designed for individuals who are passionate about maternal health and are committed to providing comprehensive care coordination services. The RN Maternity Care Manager II will engage with pregnant members to assess their health needs, establish individual goals, and facilitate access to necessary resources and services. This role requires a proactive approach to care management, ensuring that members receive the support they need to achieve optimal health outcomes during this critical time in their lives. In this position, the RN Maternity Care Manager II will serve as a single point of contact for pregnant members enrolled in the Bright Start Maternity program. Responsibilities include conducting comprehensive assessments that evaluate physical, psychosocial, environmental, and support needs. The manager will identify barriers to care and implement strategies to address these challenges, creating personalized care plans that outline both short and long-term health goals. Regular follow-up calls and coordination with healthcare providers, family members, and community organizations are essential components of this role, ensuring that members receive holistic support throughout their pregnancy. The RN Maternity Care Manager II will also be expected to attend community events to promote the maternity program and engage with members directly. This position requires a strong commitment to quality care, effective communication skills, and the ability to work collaboratively with a diverse range of stakeholders. By joining AmeriHealth Caritas, the RN Maternity Care Manager II will have the opportunity to make a significant impact on the health and well-being of mothers and their families in the Philadelphia and Montgomery counties of Pennsylvania.

Responsibilities

• Assist pregnant members in achieving optimal health throughout pregnancy, delivery, and the postpartum period.
• Engage with pregnant members and providers to assess, plan, and establish individual member goals.
• Facilitate and coordinate care for pregnant members while ensuring quality and cost-effective resource use.
• Serve as a single point of contact and advocate for pregnant members in the Bright Start Maternity program.
• Conduct comprehensive assessments of physical, psychosocial, environmental, and support needs of pregnant members.
• Identify problems/barriers and implement actions to address member issues/concerns.
• Create a plan of care to assist pregnant members in reducing/resolving problems and achieving optimal health.
• Identify both short and long-term goals and associated time frames for completion, sharing these with the member and family as appropriate.
• Document progress towards meeting goals and resolving problems.
• Implement appropriate levels of intervention based on member needs and clinical progress.
• Schedule follow-up calls as necessary and make appropriate referrals.
• Coordinate care and services with members, family members, OBGYNs, PCPs, specialists, and community-based organizations.

Requirements

• Current and unrestricted Registered Nurse licensure in Pennsylvania.
• Graduate from an accredited nursing program.
• Bachelor's degree required.
• Minimum of 3 years of clinical practice experience in Labor and Delivery/Mother-Baby/High Risk Ante-Post Partum.
• Minimum of 3 years of experience as a case manager, preferably providing telephonic case management.
• Case management experience within a managed care organization.
• Certification as a case manager preferred.
• Proficiency using MS Office (Word, Excel, Outlook), internet applications, and electronic medical record/documentation programs.
• Ability to meet deliverables within designated timeframes, strong organization and communication skills.
• Valid driver's license with car insurance.

Nice-to-haves

• Experience in community health initiatives.
• Bilingual skills to communicate with a diverse member population.

Benefits

• Flexible work solutions including remote options and hybrid work schedules.
• Competitive pay.
• Paid time off including holidays and volunteer events.
• Health insurance coverage for you and your dependents on Day 1.
• 401(k) plan.
• Tuition reimbursement.