Care Manager II

Role Overview:

The Care Manager supports maternity members through personalized care coordination and case management, helping them achieve optimal health through self-management. This role involves engaging with members, caregivers, and providers to assess needs, develop care plans, and set individual health goals.

Work Arrangement:

Remote - Associate must be located in Ohio.

Responsibilities:

Assess members to determine care coordination and case management needs for all referred members.

Completes comprehensive person-centered assessment of physical health, psycho-social health, and environmental health as social determinants of health and supportive needs.

Identifies problems/barriers for care coordination and appropriate care management interventions.

Coordinates physical, behavioral health, and social services.

Provides medication management, including regular medication reconciliation and support of medication adherence.

Creates a plan of care to assist members in reducing/resolving problems and or barriers so that members may achieve their optimal level of health.

Identifies both short—and long-term goals and associated time frames for completion. Shares goals with the member and caregiver as needed.

Identifies and implements the appropriate level of intervention based on the member’s needs and clinical progress.

Schedules follow-up calls as necessary and makes appropriate referrals. Implements actions to address member issues. Documents progress towards meeting goals and resolving problems.

Coordinates care and services.

Education & Experience:

Associate degree in Nursing required. Bachelor’s degree in Nursing preferred.

Minimum of 3 years of professional practice working with maternal health within an acute care, community health, or ambulatory care setting.

Case management experience, preferably within a managed care organization, is desired.

Licensure:

A current and unrestricted Registered Nurse (RN) or Licensed Independent Social Worker (LISW) in Ohio or multi-state compact licensure is required.

Valid driver’s license and car insurance required.

Skills & Abilities:

Ability to work independently and collaboratively in a fast-paced, dynamic environment, showing adaptability and flexibility to change.

Skilled in working effectively with culturally and demographically diverse populations. Strong organizational and time management abilities, with a proven capacity to prioritize and manage multiple tasks efficiently.

Experienced in assessing member needs, developing care plans, and supporting self-management strategies.