Remote Maternal-Child Health Program Manager

IntelliResume; North Carolina; Remote; USD 92,000 - 164,000; Full time

Job summary

UnitedHealth Group is seeking a Maternal Child Health CM Manager in Raleigh, NC, with fully remote work options. The role oversees maternity case management within Medicaid, guiding a team and coordinating care for pregnant and postpartum members.

Responsibilities include supervising clinicians, ensuring regulatory compliance, documenting in clinical systems, and driving improvements in engagement, outcomes, and cost-effectiveness. RN licensure and 5+ years in related clinical roles are required.

Qualifications

• Active, unrestricted RN license required.
• 5+ years of maternal-child health, obstetrical nursing, pediatric nursing, neonatal, case management, population health, or closely related clinical experience required.
• Experience working in Medicaid managed care or a comparable health plan environment required.
• Experience supporting clinical program operations, quality improvement activities, regulatory compliance, and performance monitoring required.

Responsibilities

• Lead, supervise, coach, and support pediatric and maternity case managers, Community Health Workers, and other program staff.
• Oversee member identification, outreach, assessment, risk stratification, individualized care plan development, monitoring, and postpartum follow-up activities.
• Ensure compliance with national, state, federal, contractual, accreditation, and organizational requirements.
• Ensure accurate, timely, and complete documentation in CommunityCare and other applicable clinical systems.
• Monitor caseload distribution, workload, staffing needs, productivity, member engagement, quality outcomes, operational metrics, and program audits.
• Review program performance reports and identify opportunities to improve engagement, quality outcomes, affordability, workflow efficiency, and member experience.
• Support market implementation of pediatric and maternity initiatives, program enhancements, pilots, modernization efforts, and strategic maternal child health priorities.
• Lead or support quality improvement projects focused on maternal and pediatric outcomes, prenatal and postpartum engagement, NICU-related trends, and care coordination performance.
• Partner with market leaders, providers, and national clinical operations teams to strengthen program performance.
• Support audit readiness, corrective action planning, regulatory reporting, and internal program reviews.

Skills

RN license

Maternal-child health

Case management

Healthcare operations

Education

RN license

Job description

UnitedHealth Group is seeking a Maternal Child Health CM Manager in Raleigh, NC, with fully remote work options. The role oversees maternity case management within Medicaid, guiding a team and coordinating care for pregnant and postpartum members.

Responsibilities include supervising clinicians, ensuring regulatory compliance, documenting in clinical systems, and driving improvements in engagement, outcomes, and cost-effectiveness. RN licensure and 5+ years in related clinical roles are required.