Manager, Revenue Execution – Americas
S&P Global
Lead OB Specialty Care Manager, RN
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Fayetteville • North Carolina • 🇺🇸 United States
Visit company websiteJob Level
Senior
About the role
- Responsible for coordinating operations and workflows related to OB and Mother/Baby case management activities in support of the North Carolina Foster Care program (CFSP).
- Manages overall healthcare costs for the foster care population via integrated (physical health/behavioral health/SDOH) case management and whole person health.
- Manages the most complex cases and provides support to case managers and care coordinators.
- Conducts specialized assessments to identify individual needs, as related to OB and associated health concerns including preventative screenings.
- Develops comprehensive care plan to address objectives and goals as identified during assessment.
- Supports member access to appropriate quality and cost-effective care and modifies plan(s) as needed.
- Coordinates with internal and external resources to meet identified needs of the member in terms of integrated (physical and behavioral) whole person care.
- Coordinates social determinants of health to meet the needs of the member and child, and incorporates the mother/baby planning into care planning.
- Works closely with various state agencies.
- Maintains knowledge of the system of care philosophy; a spectrum of effective, community-based services and supports for those with or at risk for comorbidities related to OB and/ or other challenges related to OB, that is organized into a coordinated network.
- Builds meaningful partnerships with designated populations and their families, and addresses cultural and linguistic needs, in order to help them function better at home, in the community, and throughout life.
- Provides important information including patient education of maternal/child as well as routine health, medication reconciliation, and identification of community resources and assists with arrangement of follow-up care.
- Facilitates health rounds with other clinical centered professionals to ensure whole person health.
- May lead and work on specialty projects and initiatives.
- Assists with process improvements activities.
- Trains and mentors staff.
Requirements
- Requires a degree in nursing and minimum of 7 years of clinical experience; or any combination of education and experience which would provide an equivalent background.
- Requires an active, current and valid license as an RN to practice as a health professional within the scope of licensure in the state of North Carolina.
- Requires demonstrated experience in Maternal/Child setting with knowledge of OB/GYN assessments and plans of care.
Benefits
- $3,500 SIGN ON BONUS
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical, dental, vision benefits
- Short and long term disability benefits
- 401(k) + match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
case managementhealthcare cost managementspecialized assessmentscomprehensive care planningpatient educationmedication reconciliationprocess improvementtrainingmentoring
Soft skills
coordinationcommunicationpartnership buildingcultural competenceproblem-solving
Certifications
RN license
