Nurse Case Manager I, Obstetrics
Core
A licensed nurse who manages care plans for members with complex and chronic care needs, specifically focusing on Obstetrics, Pregnancy, Labor, and Postpartum.
Role type
Nurse Case Manager I, Obstetrics
Builds
Care management plans and coordinates internal/external resources to optimize member healthcare.
Domain
Healthcare / Insurance / Obstetrics
Deliverable
client delivery
Required skills
RN licensure, care plan development, care coordination, benefit authorization, provider negotiation, discharge planning, multi-state licensure
Preferred skills
Case management experience, OB/L&D/Postpartum experience, Hospital OB experience, Case Manager certification
Responsibilities
Assess individual needs and develop care management plans, implement plans by facilitating authorizations and referrals, coordinate internal and external resources, monitor and evaluate plan effectiveness, interface with Medical Directors and Physician Advisors, negotiate reimbursement rates, assist with provider/claims problem solving
Seniority
Individual Contributor, Entry to Mid-level