Maternal Care Management Coordinator, RN

Be part of a vision for a healthier Mississippi as a Maternal Care Management Coordinator, RN.

At Blue Cross & Blue Shield of Mississippi, we’re not just about providing health insurance, we are creating a strong, supportive community which encourages every Mississippian to live their healthiest life. This mission requires a talented and motivated team with diverse sets of skills and experiences, aligned with the commitment of a healthy Mississippi.  By combining strong financial stewardship with a focus on the Health & Wellness of Mississippians, we invest in programs, partnerships, and innovations which drive quality care, lower costs, and healthier lives.

Join our team and start a meaningful career where your work supports better health outcomes for Mississippians every day.

We are seeking a Maternal Care Management Coordinator, RN, to provide individualized expert clinical support to high-risk members as they navigate the complexities of prenatal, antenatal and postpartum journey. This Coordinator deploys a multi-disciplinary approach to ensure quality and cost-effective outcomes are achieved for maternal and infant care.

• →Recommend modifications to performance measures used for Company Quality or Value-Based Programs based on research based clinical best practice guidelines.
• →Implement best practice Plan of Care for Member following thorough clinical and behavioral assessments.
• →Review inpatient care coordination, continued stay and retrospective reviews to determine service appropriateness based on medical necessity, benefit plan and medical policy.
• →Manage Member cases for care coordination as part of collaborative Health Management Team.
• →Monitor in-hospital services to promote a safe transition to the home setting, preventing complications, readmission and support positive outcomes.
• →Serve as a Member advocate and point of contact to provide the best supported care and support Members in making informed decisions in their health journey.

• Bachelor’s degree in Nursing and RN licensure that is unrestricted in the state of Mississippi.
• Three or more years of recent maternal health clinical experience.
• Intermediate proficiency using Microsoft Office (primarily Word and Excel).
• Confident communicator with the ability to listen actively, explain information clearly and provide compassionate guidance to Members and Member families.
• Ability to convey information clearly, accurately and professionally in written format ensuring that the message is easily understood, free from ambiguous or redundant language.
• Ability to organize tasks and time to orchestrate all assigned Members at once, coordinate multiple care plans, appointments and cases.

Preferred include:

• Certified Case Manager (CCM®) certification preferred.  Must obtain certification within 2 years of hire date if not certified upon hire.

• Set up a Workday account and complete your application process.
• Attach a copy of a resume and cover letter.
• Check your email for updates.
• Processes may include phone screen, testing, in-person interview (s), background and drug testing.

Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.