Maternal Care Management Coordinator, RN

Blue Cross & Blue Shield of Mississippi; Flowood (MS); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Onsite gym

Café on campus

Walking track

Medical benefits

401(k)

Paid time off

Job summary

Blue Cross & Blue Shield of Mississippi is seeking a Maternal Care Management Coordinator, RN, to provide individualized clinical support to high‑risk members through prenatal, antenatal and postpartum care. The role deploys a multidisciplinary approach to ensure quality and cost‑effective outcomes for maternal and infant care.

The position requires a BSN and an unrestricted Mississippi RN license, plus 3+ years in maternal health.

Qualifications

• Bachelor’s degree in Nursing and RN licensure unrestricted in Mississippi.
• Three or more years of maternal health clinical experience.
• Proficiency with Microsoft Office (Word, Excel).
• Strong communication and compassionate guidance to Members and families.
• Ability to organize and coordinate multiple care plans and appointments.
• CCM certification preferred; must obtain within 2 years of hire if not certified upon hire.

Responsibilities

• Provide individualized clinical support to high‑risk members navigating prenatal, antenatal and postpartum care.
• Deploy a multidisciplinary care approach to ensure quality and cost‑effective outcomes.
• Review inpatient care coordination to determine medical necessity and policy alignment.
• Manage member cases as part of the Health Management Team.
• Monitor in-hospital services to promote safe home transitions and reduce readmission.

Skills

Nursing

Care coordination

Effective communication

Time management

Education

Bachelor's degree in Nursing

RN licensure

Tools

Microsoft Office

Job description

Be part of a vision for a healthier Mississippi as a Maternal Care Management Coordinator, RN.

At Blue Cross & Blue Shield of Mississippi, we’re not just about providing health insurance, we are creating a strong, supportive community which encourages every Mississippian to live their healthiest life. This mission requires a talented and motivated team with diverse sets of skills and experiences, aligned with the commitment of a healthy Mississippi. By combining strong financial stewardship with a focus on the Health & Wellness of Mississippians, we invest in programs, partnerships, and innovations which drive quality care, lower costs, and healthier lives.

Join our team and start a meaningful career where your work supports better health outcomes for Mississippians every day.

We are seeking a Maternal Care Management Coordinator, RN, to provide individualized expert clinical support to high‑risk members as they navigate the complexities of prenatal, antenatal and postpartum journey. This Coordinator deploys a multi-disciplinary approach to ensure quality and cost‑effective outcomes are achieved for maternal and infant care.

What You’ll Do:

• Recommend modifications to performance measures used for Company Quality or Value-Based Programs based on research based clinical best practice guidelines.
• Implement best practice Plan of Care for Member following thorough clinical and behavioral assessments.
• Review inpatient care coordination, continued stay and retrospective reviews to determine service appropriateness based on medical necessity, benefit plan and medical policy.
• Manage Member cases for care coordination as part of collaborative Health Management Team.
• Monitor in-hospital services to promote a safe transition to the home setting, preventing complications, readmission and support positive outcomes.
• Serve as a Member advocate and point of contact to provide the best supported care and support Members in making informed decisions in their health journey.

Job-Specific Requirements:

• Bachelor’s degree in Nursing and RN licensure that is unrestricted in the state of Mississippi.
• Three or more years of recent maternal health clinical experience.
• Intermediate proficiency using Microsoft Office (primarily Word and Excel).
• Confident communicator with the ability to listen actively, explain information clearly and provide compassionate guidance to Members and Member families.
• Ability to convey information clearly, accurately and professionally in written format ensuring that the message is easily understood, free from ambiguous or redundant language.
• Ability to organize tasks and time to orchestrate all assigned Members at once, coordinate multiple care plans, appointments and cases.

Preferred include:

• Certified Case Manager (CCM®) certification preferred. Must obtain certification within 2 years of hire date if not certified upon hire.

Why Join Us

• Purpose-Driven Work: Make a meaningful impact on the Health & Wellness of our Members.
• Learning & Development: Build foundational knowledge in finance and investment accounting.
• Career Growth: Clear pathways to grow your career where your skills flourish, including Treasury, Financial Reporting, Accounting Operations, Internal Audit, etc.
• Healthy Culture: Work in an environment with a focus on your health which allows you to thrive. The walking track, onsite gym and café are just a few of the highlights of the campus.
• Compensation & Benefits: We offer a highly competitive compensation package that includes medical benefits, 401(k), ample paid time off and a schedule that supports true work/life balance

Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.