Care Manager GYN/OB (RN)

Pyramid Consulting, Inc; Florida; Remote; USD 54,000 - 58,000; Full time

Benefits offered by this job

Health insurance (medical, dental, vis

401(k) plan

Paid sick leave

Job summary

Pyramid Consulting, Inc. is seeking an experienced Care Manager GYN/OB (RN) for a 6+ month contract based in Florida with remote work options.

The role requires strong clinical skills, risk assessment, and care coordination across multiple healthcare providers and community resources. Responsibilities include trimester-based and ongoing assessments, care plan development, and ensuring compliance with NCQA standards.

Qualifications

• Active, unrestricted RN license required.
• Minimum 3 years of RN clinical experience.
• 5 years in care management or maternal-child health preferred.
• Experience with Medicaid Managed Care a plus.
• Strong communication and organizational skills.

Responsibilities

• Review referrals and risk stratification to identify needs.
• Conduct trimester-based and ongoing clinical assessments.
• Develop, implement, and update individualized care plans.
• Manage a caseload of high-risk Medicaid members.
• Coordinate services with providers and community resources.
• Address social determinants of health needs.
• Support transitions of care and post-discharge follow-up.
• Maintain accurate documentation and ensure NCQA compliance.

Skills

Excellent communication

Motivational interviewing

Critical thinking

Care coordination

Education

RN license (active)

Tools

EMRs

Microsoft Office

Job description

Immediate need for a talented Care Manager GYN/OB (RN). This is a 06+months contract opportunity with long-term potential and is located in FL(Remote).

Job ID:26-30621

Pay Range: $39 - $42/hour.

Employee benefits include, but are not limited to,

• health insurance (medical, dental, vision)
• 401(k) plan
• paid sick leave (depending on work location)

Key Responsibilities:

• Review referrals and risk stratification reports to identify member needs and risk factors.
• Conduct comprehensive trimester-based assessments and ongoing clinical assessments.
• Develop, implement, and update individualized care plans.
• Manage an assigned caseload of complex and high-risk Medicaid members.
• Conduct member outreach and promote active engagement in care.
• Identify and address gaps in care and barriers to accessing healthcare services.
• Coordinate services across providers, hospitals, behavioral health organizations, community agencies, and internal interdisciplinary teams.
• Identify social determinants of health (SDOH) needs and connect members with appropriate community resources.
• Facilitate referrals to medical, behavioral health, social, and community-based services.
• Support Transitions of Care (TOC) and complete required post-discharge follow-up.
• Provide education, advocacy, coaching, and support to members and families throughout pregnancy, postpartum, and other care management programs.
• Collaborate with Healthy Start programs and other maternal-child health resources.
• Monitor member progress and facilitate appropriate case closure or graduation based on program goals and outcomes.
• Maintain accurate and timely documentation of assessments, interventions, outreach, and care plans.
• Ensure compliance with NCQA, state, regulatory, and health plan documentation standards.
• Utilize care management platforms, EMRs, Microsoft Office, and organizational reporting tools.
• Work independently in a remote environment while maintaining effective communication with multidisciplinary teams.

Key Requirements and Technology Experience:

• Minimum 3 years of recent RN clinical experience.
• 5 years of nursing experience preferred, particularly in:
• Care Management
• Case Management
• Maternal-Child Health
• NICU
• Pediatrics
• Population Health
• Medicaid Managed Care
• Community Health
• Active, unrestricted RN license required.
• Strong critical-thinking and clinical assessment skills.
• Excellent communication and motivational interviewing skills.
• Ability to build rapport with diverse member populations.
• Highly organized, self-directed, and detail-oriented.
• Strong problem-solving and decision-making abilities.
• Ability to prioritize and manage a large caseload and competing priorities.
• Experience collaborating with community resources, providers, hospitals, and interdisciplinary teams.
• Knowledge of maternal and infant health programs and care management practices.
• Experience addressing social determinants of health and healthcare disparities.
• Ability to adapt to a fast-paced and changing healthcare environment.
• Data-driven mindset with a strong focus on quality outcomes and compliance.
• Ability to work independently and effectively in a remote environment.

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.