Role Overview

The Maternity Care Manager (RN) Provides support to pregnant members appropriate for care coordination and case management services in achieving their optimal level of health through self-management.  The Maternity Care Manager is responsible for engaging the member, member caregiver, and providers to assess, plan and establish individual member goals. Will facilitate and coordinate care for the members through the pre- and post-partum period while assuring quality and use of cost-effective resources.  The position will function as a single point of contact and be an advocate for members throughout their pregnancy. 

Work Arrangement 

• This is an in office position.   Associate responsible for commuter costs.  Company has a commuter benefit program. 
• Must reside in the DC metro area.  Office located in close proximity to two Metro stations. 
• Must engage directly with identified members through face-to-face visits in the community as needed
   

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, makes appropriate referrals. Implements 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 and Experience

• Certification as a case manager preferred (as documented and accepted on URAC's website www.urac.org) 
• Qualified candidates must reside in the DC Metro area. 
• Willing to meet face to face with the members in the community, on occasion, based on needs.  
• Minimum of 3+ years of case management experience supporting Medicaid members and/or pediatric populations within a managed care organization preferred
• 3+ years of nursing experience required, working with Medicaid populations, either in the hospital or community health setting. 
   

Licensure

• Current and unrestricted Registered Nurse licensure in the District of Columbia 
• Valid driver's license with car insurance is required
   

Skills & Abilities

• Proficiency in MS Office (Word, Excel, Outlook, Teams), internet applications, and electronic medical record/documentation systems is essential

The range displayed in this job posting reflects the minimum and maximum for new hire salaries for the position in the D.C. office.  Within the range, individual pay is determined by additional factors, including, without limitation, job-related skills, experience, and relevant education, certifications, or training.  

AmeriHealth Caritas associates are eligible to participate in our annual incentive program and will also receive our benefits package, consisting of medical, vision, dental, life insurance, disability insurance, 401(k), paid time off and more.  

The targeted hiring range for this role is expected to be between $83,400 and 113,600. 

Your career starts now. We’re looking for the next generation of healthcare leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. We'd like to hear from you if you want to make a difference.

Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com. 

Our Comprehensive Benefits Package

Flexible work solutions include remote options, 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), tuition reimbursement, and more.