Care Manager – Care Management for High-Risk Pregnancy

Alliance Health

. Provide comprehensive, member-centered care management services for eligible high-risk pregnant members enrolled in Alliance Health’s Care Management for High-Risk Pregnancy program .

Posted 10/14/2026full-timeFayetteville • North Carolina • United StatesJuniorMid-Level💰 $69,592 - $88,729 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care management for high-risk pregnancies, including prenatal and postpartum care coordination, behavioral health integration, and effective communication with diverse stakeholders. Proficient in developing individualized care plans and addressing social determinants of health to enhance member engagement and outcomes.

Highest-signal resume keywords

Care ManagementHigh-Risk Pregnancy SupportBehavioral Health IntegrationLicensed Clinical Social Worker (LCSW)Community Health Coordination

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care CoordinationCase ManagementDischarge PlanningUtilization ManagementAssessment CompletionCare Plan DevelopmentData AnalysisRisk StratificationDocumentationMember Engagement Strategies

Soft Skills

CommunicationCollaborationProblem-SolvingCultural ResponsivenessOrganization

Tools & Technologies

Care Management Technology

Certifications & Qualifications

Licensed Clinical Social Worker (LCSW)Registered Nurse (RN)

Industry Keywords

Maternal HealthMedicaid Managed CareSocial Drivers of HealthTailored PlanCommunity Resources

About the role

Key responsibilities & impact

Provide comprehensive, member-centered care management services for eligible high-risk pregnant members enrolled in Alliance Health’s Care Management for High-Risk Pregnancy program
Support early identification, outreach, assessment, care planning, provider coordination, education, barrier resolution, social needs referrals, postpartum transition planning, and documentation
Support members identified for CMHRP during pregnancy and postpartum
Provide subject matter expertise regarding members’ physical and/or behavioral health to support a whole-person approach to care management
Collaborate with Alliance staff, providers, physicians, specialty care providers, community partners, and stakeholders
Conduct timely outreach and engagement; confirm eligibility, explain services, support enrollment, and document declinations or inability to contact
Complete assessments covering pregnancy-related risks, behavioral health needs, social drivers of health, prenatal-care barriers, member goals, and support needs
Develop and maintain individualized care plans with members, providers, and other supports
Provide education and support related to prenatal care, warning signs, medication adherence, appointments, postpartum care, infant handoffs, and community resources
Identify and help resolve transportation, food, housing, language access, behavioral health, substance use, interpersonal safety, and other social-health barriers
Escalate urgent maternal-health, behavioral-health crisis, safety, missed-appointment, or unresolved-access concerns
Coordinate with OB providers, pregnancy-management providers, Advanced Medical Homes, hospitals, behavioral-health providers, pharmacies, Local Health Departments, and community partners
Participate in case reviews, supervision, quality audits, training, workflow refinement, and performance improvement
Document outreach, assessments, care plans, referrals, communications, escalations, and case closures accurately and timely
Review, validate, and interpret patient-identification and risk-stratification data; recommend care-management adjustments
Analyze member needs, guide staff-training development, identify resource needs, and assess workflow consistency
Travel between Alliance offices, meetings, sponsored events, members, providers, stakeholders, and court hearings as required

Requirements

What you’ll need

Master’s degree from an accredited college or university in Human Services or related field and at least two (2) years of full-time, post graduate degree experience providing care management, case management, care coordination, discharge planning, or utilization management to members with Behavioral Health and Physical Health conditions in a behavioral health, medical, or managed care setting
Fully or provisionally licensed in the State of North Carolina as a LCSW, LMFT, LCAS, LCMHC, or LPA
OR graduation from a school of nursing and licensure as a Registered Nurse and three (3) years of full-time, post degree experience
Must be licensed as a Registered Nurse in the State of North Carolina
Experience in care management, maternal health, high-risk pregnancy support, Medicaid managed care, behavioral health, community health, or human services preferred
Knowledge of prenatal and postpartum care coordination, social drivers of health, behavioral health needs, community resources, and member engagement strategies preferred
Knowledge of the Tailored Plan and Medicaid Direct Transformation
Knowledge of Tailored Plan standards or procedures
Strong communication, engagement, documentation, organization, cultural responsiveness, problem-solving, and collaboration skills
Ability to build trust with members, coordinate across providers and community partners, manage multiple priorities, recognize escalation needs, use care management technology, and follow standardized workflows while adapting support to individual member needs
Satisfactory background and MVR (Motor Vehicle Record) check required after offer acceptance and before start date

Benefits

Comp & perks

Medical, Dental, Vision, Life, Long Term Disability
Generous retirement savings plan
Flexible work schedules including hybrid/remote options
Paid time off including vacation, sick leave, holiday, management leave
Dress flexibility