RN Case Manager

Job Description

Job Description

Actalent is Hiring a Hybrid/Remote RN Case Manager!!

Job Description

The OB Case Manager (RN) coordinates comprehensive care for maternal and child health populations, ensuring safe, evidence-based interventions across the continuum of care. This role focuses on intake assessments, individualized care planning, discharge coordination, and continuous monitoring of clinical outcomes for obstetric and neonatal patients. The position supports Medicaid contract compliance and promotes improved maternal and neonatal outcomes while managing a high-volume caseload and maintaining high quality standards.

Responsibilities

• Conduct thorough intake assessments for pregnant and postpartum individuals and their infants to identify clinical, psychosocial, and social determinant needs.
• Develop individualized, evidence-based care plans for maternal and child health populations, including high-risk antepartum and NICU cases.
• Coordinate care across the continuum, including inpatient, outpatient, and community settings, to ensure seamless transitions and continuity of care.
• Lead and manage discharge planning activities, ensuring appropriate follow-up appointments, home care services, and community resource referrals.
• Perform ongoing monitoring and evaluation of clinical outcomes, adjusting care plans as needed to improve maternal and neonatal health results.
• Provide patient and family education on disease management, pregnancy and postpartum care, newborn care, and available support services.
• Conduct outbound calls to patients and families to support care coordination, follow up on care plans, and reinforce education and engagement.
• Respond to inbound patient calls, addressing questions, concerns, and barriers to care in a timely and compassionate manner.
• Utilize case management and utilization management principles to ensure appropriate use of services and adherence to clinical guidelines.
• Support Medicaid members by navigating benefits, addressing access issues, and coordinating services in alignment with program requirements.
• Document all assessments, interventions, communications, and outcomes accurately and thoroughly in electronic health record (EHR) systems.
• Maintain strong organizational practices to manage a high-volume caseload while meeting productivity metrics and quality benchmarks.
• Collaborate with multidisciplinary teams, including physicians, nurses, social workers, and community partners, to optimize patient outcomes.
• Apply knowledge of Medicaid and Medicare regulations to ensure compliance in case management activities and documentation.
• Participate in orientation, training sessions, and ongoing professional development related to care coordination, EPIC, and other EHR platforms.
• Engage patients using motivational interviewing and culturally competent communication to enhance adherence, self-management, and satisfaction.
• Leverage familiarity with community resources such as Healthy Start, WIC, and SNAP to connect patients with supportive services.
• Contribute to quality initiatives related to maternal health metrics, including HEDIS measures, by ensuring accurate data capture and follow-through.
• Adapt to hybrid work expectations, including onsite presence as required and effective remote case management practices.

Essential Skills

• Active, unrestricted Registered Nurse (RN) license in the state of Florida.
• 3–5 years of clinical experience in obstetrics, high-risk antepartum, or neonatal intensive care (NICU).
• 3–5 years of experience in case management within a managed care organization, health plan, or insurance carrier.
• Bachelor’s Degree in Nursing (BSN) preferred; Master’s Degree in Nursing or related field is an added advantage.
• Certified Case Manager (CCM) or similar case management certification is highly desirable.
• Experience and familiarity with Medicaid and Medicare regulations as they relate to case management and utilization management.
• Demonstrated experience with utilization management processes and criteria.
• Experience supporting Medicaid members in a clinical or managed care setting.
• Strong organizational skills with the ability to manage a high-volume caseload and meet productivity metrics.
• Excellent documentation skills with attention to detail and accuracy.
• Proficiency in care coordination and discharge planning across multiple care settings.
• Ability to work independently with minimal supervision while maintaining quality standards.
• Competence in using electronic health record (EHR) systems for documentation and care coordination.
• Ability to conduct patient care, patient education, and disease management via outbound and inbound patient calls.

Work Environment

This role operates in a remote work environment based in Florida. The schedule runs Monday through Friday from 8:30 a.m. to 5:00 p.m., with a 30-minute lunch break and flexibility in start times. Orientation occurs onsite on Mondays for computer pickup, followed by onsite training sessions on Tuesdays and Thursdays and dedicated EPIC training on Wednesdays.

This is a Contract to Hire position based out of West Palm Beach, FL.

The pay range for this position is $38.00 - $44.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

This is a hybrid position in West Palm Beach,FL.

This position is anticipated to close on Sep 1, 2026.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email View email address on ziprecruiter.com for other accommodation options.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.