RN Maternity Case Manager - High-Risk Pregnancy Care

WebTPA; United States; On-site; USD 85,000 - 110,000; Full time

Job summary

WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience delivering tailored benefit solutions and managing health plans. The RN Maternity Case Manager role sits in the Case Management department focusing on wellness, education, and high-risk pregnancy care path.

You'll assess health status, coordinate care with families and providers, develop cost-conscious treatment plans, monitor outcomes, and report results to clients while maintaining

Qualifications

• 5+ years professional work experience in clinical nursing and patient assessment.
• Bachelor’s degree or related equivalent work experience.
• Graduate of an accredited school of nursing.
• RN licensure in good standing.
• RN Compact State Licensure.

Responsibilities

• Assess member health status and care coordination needs; may include discharge planning.
• Contact patient, family, physicians, and providers; coordinate with employer/client.
• Identify alternative care plans approved by all parties to balance quality care and cost.
• Monitor health status and adjust care plan as member needs change.
• Identify services and providers to provide timely, cost-effective care.
• Develop and implement case management goals with documented plans.
• Report outcomes and interpret health plans to authorize/co-ordinate care.

Skills

5+ years professional work experience

Medical terminology

Utilization management

Cross-functional collaboration

CCM certification

Travel availability

Education

Bachelor's degree or related equivalent

Graduate of an accredited school of nursing

RN licensure in good standing

RN Compact State Licensure

Job description

WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience delivering tailored benefit solutions and managing health plans. The RN Maternity Case Manager role sits in the Case Management department focusing on wellness, education, and high-risk pregnancy care path.

You'll assess health status, coordinate care with families and providers, develop cost-conscious treatment plans, monitor outcomes, and report results to clients while maintaining