Care Manager GYN/OB (RN)

Immediate need for a talented Care Manager GYN/OB (RN). This is a 06+months contract opportunity with long-term potential and is located in FL(Remote). Job ID:26-30621 Pay Range: $39 - $42/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision) 401(k) plan paid sick leave (depending on work location) Key Responsibilities: Review referrals and risk stratification reports to identify member needs and risk factors. Conduct comprehensive trimester-based assessments and ongoing clinical assessments. Develop, implement, and update individualized care plans. Manage an assigned caseload of complex and high-risk Medicaid members. Conduct member outreach and promote active engagement in care. Identify and address gaps in care and barriers to accessing healthcare services. Coordinate services across providers, hospitals, behavioral health organizations, community agencies, and internal interdisciplinary teams. Identify social determinants of health (SDOH) needs and connect members with appropriate community resources. Facilitate referrals to medical, behavioral health, social, and community-based services. Support Transitions of Care (TOC) and complete required post-discharge follow-up. Provide education, advocacy, coaching, and support to members and families throughout pregnancy, postpartum, and other care management programs. Collaborate with Healthy Start programs and other maternal-child health resources. Monitor member progress and facilitate appropriate case closure or graduation based on program goals and outcomes. Maintain accurate and timely documentation of assessments, interventions, outreach, and care plans. Ensure compliance with NCQA, state, regulatory, and health plan documentation standards. Utilize care management platforms, EMRs, Microsoft Office, and organizational reporting tools. Work independently in a remote environment while maintaining effective communication with multidisciplinary teams. Key Requirements and Technology Experience: Minimum 3 years of recent RN clinical experience. 5 years of nursing experience preferred , particularly in: Care Management Case Management Maternal-Child Health NICU Pediatrics Population Health Medicaid Managed Care Community Health Active, unrestricted RN license required. Strong critical-thinking and clinical assessment skills. Excellent communication and motivational interviewing skills. Ability to build rapport with diverse member populations. Highly organized, self-directed, and detail-oriented. Strong problem-solving and decision-making abilities. Ability to prioritize and manage a large caseload and competing priorities. Experience collaborating with community resources, providers, hospitals, and interdisciplinary teams. Knowledge of maternal and infant health programs and care management practices. Experience addressing social determinants of health and healthcare disparities. Ability to adapt to a fast-paced and changing healthcare environment. Data-driven mindset with a strong focus on quality outcomes and compliance. Ability to work independently and effectively in a remote environment. Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #J-18808-Ljbffr Pyramid Consulting, Inc