Maternity Care RN Manager II

2 weeks ago

Philadelphia, Pennsylvania, United States Amerihealth Caritas Health Plan Full time
Maternity Care RN Manager II

Your career journey begins here. We are in search of the next wave of healthcare pioneers.

At AmeriHealth Caritas, we are dedicated to assisting individuals in accessing care, maintaining wellness, and fostering healthy communities.

As a prominent entity in healthcare solutions, we provide our team members the chance to make a significant impact on the lives of countless individuals through our extensive range of products, services, and acclaimed programs.

AmeriHealth Caritas is eager to welcome skilled, enthusiastic professionals to our organization. Together, we can cultivate healthier communities. If you aspire to create a positive change, we invite you to connect with us.

Based in Newtown Square, PA, AmeriHealth Caritas is a purpose-driven organization with over three decades of expertise. We deliver comprehensive, outcome-focused care to those who require it the most.

We provide integrated managed care offerings, pharmaceutical benefit management, specialty pharmacy services, behavioral health support, and various administrative services.

Learn more about us at

Key Responsibilities:


The Maternity Care RN Manager II supports expectant members eligible for care coordination services in achieving optimal health throughout their pregnancy, delivery, and postpartum phases.

This role is accountable for engaging with the expectant member and healthcare providers to evaluate, strategize, and set individual member objectives.

The Maternity Care RN Manager II facilitates and coordinates care for expectant members while ensuring quality and the utilization of cost-effective resources.

This position serves as a single point of contact and advocates for expectant members in the Bright Start Maternity program.

Evaluates expectant members to ascertain care coordination requirements. Conducts a thorough assessment of physical, psychosocial, environmental, and support needs. Identifies challenges and implements strategies to address member concerns.

Develops a care plan to assist expectant members in alleviating or overcoming challenges, enabling them to achieve their optimal health.

Establishes both short-term and long-term objectives with associated timelines for completion. Shares objectives with the member and family as appropriate and documents progress towards achieving goals and resolving issues. Identifies and applies the suitable level of intervention based on the member's needs and clinical advancement. Schedules follow-up communications as necessary and makes appropriate referrals. Coordinates care and services with the member, family members, OBGYN, PCP, specialists, and community-based organizations as needed.

Qualifications:

  • Must reside in the designated areas.
  • Must be willing to participate in community events supporting members enrolled in our maternity program.
  • Current and unrestricted Registered Nurse licensure required.
  • Graduate from an accredited nursing program. Bachelor's degree is mandatory.
  • Minimum of 3 years of clinical practice experience in Labor and Delivery/Mother-Baby/High Risk Ante-Post Partum.
  • Minimum of 3 years of experience as a case manager, preferably in telephonic case management.
  • Case management experience within a managed care setting.
  • Certification as a case manager is preferred.
  • Proficiency in MS Office (Word, Excel, Outlook), internet applications, and electronic medical record documentation.
  • Ability to meet deliverables within specified timeframes, with strong organizational and communication skills.
  • Valid driver's license with appropriate insurance.
Diversity, Equity, and Inclusion

At AmeriHealth Caritas, we strive to ensure that everyone feels valued, supported, and comfortable being themselves. Our commitment to equity ensures that all associates have a fair opportunity to reach their full potential. We put these principles into practice daily by acting with integrity and respect.

We unite to advocate against injustice and dismantle barriers to foster a more inclusive and equitable workplace.

Embracing the diverse thoughts and perspectives that constitute our workforce makes our organization more vibrant, innovative, and better equipped to support the individuals and communities we serve.

We prioritize the well-being of our associates so they can focus on maintaining the health of our members.

Our Comprehensive Benefits Package


Flexible work solutions including remote options, hybrid work schedules, competitive compensation, paid time off including holidays and volunteer opportunities, health insurance coverage for you and your dependents from day one, 401(k), tuition reimbursement, and more.

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