Maternity Care Manager II

AmeriHealth Caritas; Fayetteville (NC); Remote; USD 60,000 - 75,000; Full time

Job summary

A leading healthcare organization is seeking a Care Manager II to manage care for pregnant Members in the Fayetteville area. This remote position involves coordinating services, developing care plans, and collaborating with healthcare teams to improve health outcomes. Candidates must possess an RN license and have experience in high-risk maternal care. Join us to make a significant impact on community health and well-being.

Benefits

Flexible Work Options

Competitive Pay

Paid Time Off

Health Insurance from Day 1

401(k)

Tuition Reimbursement

Qualifications

• Minimum of 3 years in high-risk ante/post-partum care.
• Case management experience within managed care is desired.
• Valid driver's license required.

Responsibilities

• Manage and coordinate care for pregnant Members with various health conditions.
• Develop care plans in collaboration with Members and providers.
• Support Members during care transitions and maintain accurate documentation.

Skills

Communication

Critical Thinking

Organizational Skills

Cultural Competence

Education

Associate Degree in Nursing

Bachelor's Degree in Nursing

Tools

MS Office

Electronic Medical Records

Job description

This is a remote/field-based position with up to 50% travel within the Fayetteville, North Carolina region. RN required.

Responsibilities:

The Care Manager II is responsible for managing and coordinating care, services, and social determinants of health for pregnant Members with acute, chronic, medically complex, and/or behavioral health conditions and other health needs. Serves as the primary contact for the care team, including Members, physicians, and community supports, to guide members toward optimal health. Utilizes assessment, communication skills, critical thinking, and clinical knowledge to identify issues, gaps, and barriers to care. Develops a care plan through shared decision-making with the Member/caregiver and in collaboration with providers and care team members to improve health outcomes, treatment compliance, and self-management. Key responsibilities include:

• Supporting Members during care transitions through assessment, care coordination, education, referrals, and evaluation of the discharge plan.
• Reviewing medication lists, educating Members on pharmacy needs, and counseling on side effects and mitigation strategies.
• Evaluating, monitoring, and updating the care plan through follow-ups based on Member progress and needs.
• Establishing contacts to collaborate with community, medical, and behavioral health teams.
• Maintaining accurate documentation of Member interactions in electronic care management platforms.
• Monitoring utilization, coordinating services, making referrals, and addressing quality issues.
• Developing knowledge of care management platforms, programs, policies, and regulatory requirements.
• Identifying cases for care management rounds and following up with providers to achieve optimal outcomes.
• Supporting a positive, collaborative, and culturally competent workplace environment. Face-to-face visits may be required at various locations for education and assessment.
• Performing other duties as assigned.

Education/Experience:

• Must be local to Fayetteville/Wilmington, NC for face-to-face Member engagement.
• Current, unrestricted NC RN license. Associate degree in nursing required; Bachelor’s preferred.
• Minimum of 3 years of practice in high-risk ante/post-partum care, labor and delivery, or mother/baby care within an acute, community, or ambulatory setting.
• Case management experience, preferably within managed care, is desired.
• Ability to work independently, adapt to change, and collaborate effectively in a fast-paced environment.
• Ability to work effectively with a diverse population, demonstrating cultural competence.
• Strong organizational and time management skills.
• Experience in assessment, care planning, and self-management education.
• Proficiency in MS Office, SharePoint, internet applications, and electronic medical records.
• Valid driver’s license.

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

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. We offer opportunities to impact millions through our products, services, and programs. Join us to make a difference.

Headquartered in Newtown Square, PA, with over 30 years of experience, we deliver comprehensive, outcomes-driven care to those who need it most. Our services include managed care, pharmacy benefits, behavioral health, and administrative services.

Discover more at www.amerihealthcaritas.com.

Diversity, Equity, and Inclusion

We value and support a diverse, inclusive workplace where everyone feels valued. Our commitment to equity involves acting with integrity, respecting all, and breaking down barriers to foster an equitable environment. Celebrating diverse perspectives makes us more vibrant, innovative, and better equipped to serve our communities.

We prioritize the happiness of our associates so they can focus on member health.

Our Benefits:

Flexible work options, competitive pay, paid time off, health insurance from Day 1, 401(k), tuition reimbursement, and more.