Care Manager, Mom and Baby

CareSource

. Collaborate with interdisciplinary care teams, providers, community organizations, and faith-based organizations .

Posted 11/11/2026full-timeRemote • United StatesMid-LevelSenior💰 $62,700 - $100,400 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in conducting health and psychosocial assessments, developing individualized care plans, and coordinating case management services while adhering to clinical standards and regulatory requirements. Proficient in engaging with interdisciplinary teams and educating members about treatment options and community resources.

Highest-signal resume keywords

Registered Nurse LicenseCase Management CertificationHealth Equity ApproachesInterdisciplinary Care CoordinationMedicaid/Medicare Managed Care Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Health AssessmentsCare Plan DevelopmentClinical OversightQuality ManagementMotivational InterviewingTrauma-Informed CareDocumentationResource Utilization MonitoringBarriers ManagementProcess Improvement

Soft Skills

Critical ThinkingDecision-MakingProblem-SolvingOrganizational SkillsEffective Communication

Tools & Technologies

Microsoft OfficeTelephonic CommunicationElectronic Communication

Certifications & Qualifications

Registered Nurse LicenseCase Management Certification

Industry Keywords

NCQA StandardsCMSA StandardsHEDISDisease ManagementCommunity ResourcesSupportive Medication Reconciliation

About the role

Key responsibilities & impact

Collaborate with interdisciplinary care teams, providers, community organizations, and faith-based organizations
Conduct health and psychosocial assessments using strength-based, trauma-informed, motivational interviewing, and health-equity approaches
Facilitate interdisciplinary care team meetings
Establish professional member relationships through telephonic or electronic communication
Develop and update individualized, person-centered care plans
Identify and manage barriers to care-plan goals
Implement interventions based on clinical standards and best practices
Coordinate case management, care transitions, and community services
Educate members and natural supports about treatment options, community resources, and insurance benefits
Document assessments, care coordination activities, and member responses
Monitor healthcare resource utilization, clinical variance, and benefits management
Verify member eligibility, enrollment history, demographics, and health status
Oversee psychosocial and behavioral assessments and care-plan execution
Inform providers about Care Management services and benefits
Support ICDS model-of-care orientation and training for facility and community providers
Identify and address gaps in care and access
Coordinate post-discharge care and transitions to appropriate levels of care
Adjust intervention intensity according to guidelines, member preferences, healthcare needs, and care-plan progress
Provide clinical oversight and direction to unlicensed team members
Assess process improvements and share repeatable improvements with leadership
Adhere to NCQA and CMSA standards and perform other related duties

Requirements

What you’ll need

Associate of Science (A.S.) degree from an accredited nursing program required, or Bachelor's degree in a healthcare field required
Equivalent years of relevant work experience may be accepted in lieu of required education
Three (3) years of experience in nursing, social work, counseling, or a healthcare profession required
Current unrestricted clinical license in state of practice as a Registered Nurse, Social Worker, or Professional Clinical Counselor required
Licensure may be required in multiple states as applicable based on work assigned
Strong understanding of Quality, HEDIS, disease management, supportive medication reconciliation, and adherence
Intermediate proficiency with Microsoft Office, including Outlook, Word, and Excel
Knowledge of local, state, and federal healthcare laws and regulations and company case management policies
Knowledge of and adherence to Case Management Society of America (CMSA) standards
Critical listening, thinking, decision-making, problem-solving, organizational, and time-management skills
Ability to communicate effectively with diverse individuals
Ability to multitask and work independently within a team environment
Awareness of community and state support resources
Master's or Bachelor's degree associated with clinical licensure preferred
Three (3) years of Medicaid and/or Medicare managed care experience preferred
Three (3) years of maternity, NICU, or postpartum experience preferred
Case Management Certification highly preferred

Benefits

Comp & perks

Bonus tied to company and individual performance may be available
Comprehensive total rewards package
Flexible hours, including possible evenings and/or weekends as needed
Remote work arrangement
Travel is not typically required