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Job description
Position Summary:
Join our Population Health & Concierge Care team as an RN Care Manager focused on maternal and child health. In this role, you'll use your clinical expertise to support women throughout pregnancy and postpartum, coordinate care for high-risk pregnancies, and help mothers and newborns access the services they need for healthier outcomes. You'll work alongside providers, specialists, community partners, and families to identify barriers to care, develop individualized care plans, provide education, and connect members with meaningful resources.
This is an opportunity for an experienced OB nurse to take your clinical knowledge beyond the bedside and make an impact across the entire pregnancy journey-from prenatal care through postpartum and the newborn's first well-baby visit. The existing JD specifically calls for care management throughout pregnancy, postpartum follow-up, and linkage to ongoing primary care for both mother and newborn.
Qualifications:
Bachelor's degree in Nursing required
Active Florida RN license required
3-5 years of clinical nursing experience, including Labor & Delivery, high-risk antepartum, and/or NICU
3-5 years of experience in managed care, health plans, insurance, or case management , preferably in maternal/child health
Experience with care coordination, utilization management, authorizations, and/or appeals
Knowledge of Medicaid, Medicare, or other healthcare programs and regulatory requirements
Certified Case Manager (CCM) preferred
Experience with EPIC and/or JIVA preferred
Master's degree in Nursing preferred
Essential Duties and Responsibilities: Manage a caseload of pregnant and postpartum members, including those with high-risk or complex medical needs.
Complete comprehensive assessments and develop individualized care plans based on medical, psychosocial, and educational needs.
Coordinate care with OB providers, specialists, hospitals, primary care providers, community organizations, and other members of the care team.
Support members throughout pregnancy and postpartum, helping ensure appropriate prenatal, postnatal, and newborn care.
Identify barriers to care and connect members with resources such as Healthy Start, WIC, SNAP, transportation, housing, food, and behavioral health services.
Provide patient-centered education on pregnancy, self-care, healthy behaviors, preventive care, and chronic condition management.
Monitor care plans, appointments, screenings, clinical outcomes, and follow-up needs.
Use motivational interviewing and strong communication skills to engage members and encourage self-management.
Maintain accurate clinical documentation and ensure care is delivered in accordance with applicable quality, regulatory, and organizational standards.
Collaborate with multidisciplinary teams to improve maternal and newborn health outcomes.
This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.
Work Schedule:
Community Care Plan is currently following a hybrid work schedule. The company reserves the right to change the work schedules based on the company needs.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear. The employee is frequently required to stand, walk, and sit. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee may occasionally lift and/or move up to 15 pounds.
Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. The environment includes work inside/outside the office, travel to other offices, as well as domestic, travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are committed to fostering, cultivating, and preserving a culture of diversity, equity and inclusion.
Background Screening Notice:
In compliance with Florida law, candidates selected for this position must complete a Level 2 background screening through the Florida Care Provider Background Screening Clearinghouse.
The Clearinghouse is a statewide system managed by the Agency for Health Care Administration (AHCA) and is designed to help protect children, seniors, and other vulnerable populations while streamlining the screening process for employers and applicants.
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Who can apply
Review the original listing for work authorization, qualifications and employer requirements.