Role Overview:

The Care Manager supports maternity members through personalized care coordination and case management, helping them achieve optimal health through self-management. This role involves engaging with members, caregivers, and providers to assess needs, develop care plans, and set individual health goals.

 Work Arrangement:

• Remote - Associate must be located in Ohio. 

 Responsibilities:

• Assess members to determine care coordination and case management needs for all referred members. 
• Completes comprehensive person-centered assessment of physical health, psycho-social health, and environmental health as social determinants of health and supportive needs.
• Identifies problems/barriers for care coordination and appropriate care management interventions.   
• Coordinates physical, behavioral health, and social services.
• 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 as needed.      
• Identifies and implements the appropriate level of intervention based on the member’s needs and clinical progress.
• Schedules follow-up calls as necessary and makes appropriate referrals. Implements actions to address member issues.  Documents progress towards meeting goals and resolving problems.
• Coordinates care and services.

 Education & Experience:

• Associate degree in Nursing required. Bachelor’s degree in Nursing preferred.
• Minimum of 3 years of professional practice working with maternal health within an acute care, community health, or ambulatory care setting.
• Case management experience, preferably within a managed care organization, is desired.

 Licensure:

• A current and unrestricted Registered Nurse (RN) or Licensed Independent Social Worker (LISW) in Ohio or multi-state compact licensure is required. 
• Valid driver’s license and car insurance required.

 Skills & Abilities:

• Ability to work independently and collaboratively in a fast-paced, dynamic environment, showing adaptability and flexibility to change.
• Skilled in working effectively with culturally and demographically diverse populations. Strong organizational and time management abilities, with a proven capacity to prioritize and manage multiple tasks efficiently.
• Experienced in assessing member needs, developing care plans, and supporting self-management strategies.