OB Case Manager RN

OB RN Case Manager

The OB RN Case Manager 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 ongoing monitoring of clinical outcomes, with a strong emphasis on documentation, care coordination, and quality improvement. The position supports compliance with Medicaid contracts and drives improved maternal and neonatal outcomes within a mission-driven, community-focused setting.

Responsibilities

• Conduct thorough intake assessments for pregnant and postpartum individuals and their newborns to identify clinical, psychosocial, and resource needs.
• Develop individualized, evidence-based care plans for maternal and child health populations, including high-risk antepartum and NICU patients.
• 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 safe and timely transitions from hospital to home or other care settings.
• Monitor and evaluate clinical outcomes for maternal and neonatal populations, adjusting care plans as needed to support optimal results.
• Provide patient and family education on disease management, pregnancy and postpartum care, newborn care, and available community resources.
• Perform needs assessments and facilitate appropriate resource referrals, including programs such as Healthy Start, WIC, and SNAP when applicable.
• Utilize case management and utilization management principles to ensure appropriate use of services and alignment with health plan guidelines.
• Support Medicaid members by coordinating benefits, services, and interventions that align with Medicaid contract requirements.
• Document all assessments, interventions, care plans, and outcomes accurately and timely within electronic health records (EHR) and other required systems.
• Maintain a high-volume caseload while adhering to quality standards, productivity metrics, and regulatory requirements.
• Collaborate effectively with multidisciplinary teams, including physicians, social workers, and other healthcare professionals, to optimize maternal and child health outcomes.
• Use EHR systems and Microsoft Office tools to track, report, and communicate patient care activities and outcomes.
• Apply knowledge of maternal health quality measures, including HEDIS metrics, to support quality improvement initiatives when applicable.
• Incorporate motivational interviewing and patient engagement strategies to support behavior change and promote adherence to care plans.
• Ensure compliance with Medicaid and Medicare regulations as they relate to case management and utilization management activities.
• Demonstrate cultural competence and sensitivity in all patient interactions, promoting trust and engagement with diverse populations.
• Adapt to changing priorities, hybrid work schedules, and evolving program needs while maintaining consistent, high-quality care coordination.

Essential Skills

• Active Registered Nurse (RN) license in the state of Florida.
• 35 years of clinical experience in obstetrics (OB), high-risk antepartum, or neonatal intensive care unit (NICU) settings.
• 35 years of experience in case management within a managed care organization, health plan, or insurance carrier.
• Experience with utilization management processes and criteria.
• Experience supporting Medicaid members in a clinical or case management capacity.
• Demonstrated proficiency in care coordination and discharge planning.
• Strong organizational skills with the ability to manage a high-volume caseload while maintaining quality standards.
• Excellent documentation skills and attention to detail in electronic health records (EHR) and related systems.
• Ability to work independently, prioritize tasks effectively, and meet productivity metrics.
• Competence in needs assessment, care planning, resource referral, patient education, and disease management.

Additional Skills & Qualifications

• Bachelor's Degree in Nursing; a Master's Degree in Nursing or a related field is preferred.
• Strong communication and interpersonal skills, with the ability to build rapport with patients, families, and interdisciplinary team members.
• Proven ability to work collaboratively within a multidisciplinary team environment.
• Proficiency with Microsoft Office applications and electronic health record (EHR) platforms, including EPIC training as part of onboarding.
• Flexibility to adapt to changing priorities, program needs, and hybrid work schedules.
• Experience with InterQual or similar clinical criteria tools.
• Certified Case Manager (CCM) or similar case management certification, or a strong understanding of case management standards.
• Knowledge of Medicaid and Medicare regulations related to case management and utilization management.
• Experience with motivational interviewing techniques to support patient behavior change and engagement.
• Familiarity with maternal health quality measures, including HEDIS, and their application in managed care settings.
• Previous experience in managed care or health plan environments.
• Cultural competence and strong patient engagement skills, particularly with diverse maternal and child health populations.
• Knowledge of community resources such as Healthy Start, WIC, SNAP, and other social support programs.
• Ability to thrive in a hybrid work environment that combines onsite and remote responsibilities.

Work Environment

This role operates in a hybrid work environment based in Florida. The schedule typically runs Monday through Friday from 8:30 AM to 5:00 PM with a 30-minute lunch, and offers flexibility in start times. The position requires onsite presence on Tuesdays and during designated training and orientation sessions. Initial onboarding includes onsite attendance on Mondays for computer pickup, onsite training sessions on Tuesdays and Thursdays, and onsite EPIC training on Wednesdays. After the initial training period, the role transitions to a primarily hybrid arrangement with occasional onsite visits to the Sunrise, Florida location. The work involves extensive use of electronic health records, including EPIC, and Microsoft Office tools to manage documentation, care coordination, and communication. The environment is mission-driven and focused on improving maternal and child health outcomes across Florida, offering flexibility, training opportunities, and a supportive culture that values professional growth, collaboration, and measurable impact on community health.

Job Type & Location

This is a Contract to Hire position based out of Sunrise, FL.

Pay and Benefits

The pay range for this position is $38.00 - $43.00/hr. 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)

Workplace Type

This is a hybrid position in Sunrise, FL.

Application Deadline

This position is anticipated to close on Jun 11, 2026.