Case Manager OB

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.AmeriChoice, a UnitedHealth Group company, is a recognized leader and innovator in providing managed health care solutions to its membership, which includes Medicaid, Medicare and SCHIP beneficiaries.  With over a decade of growth and success, we are poised for continued expansion of our services in this dynamic marketplace. Our commitment to this specialized market makes a genuine difference in the lives of our 1.8 million members. Join us, do rewarding work, and build a great career.   Summary:Responsible for coordinating care for members requiring obstetrical and gynecological services  Responsibilities:Monitors and tracks all women identified as being pregnantCoordination of services for women requiring gynecological carePerforms risk stratification from OB HRAS and other risk assessments formsVerify, coordinate and modify plan of care with provider care as needed. Face to face follow up and Health Education with member as dictated by careplanTelephonic follow up with health education as dictated by careplanAssure that all postpartum women and their newborn receive a PPVCoordinate transportation as necessary for medical appointmentsMake appropriate referrals to Community Agencies, Behavioral Health, Quality Management and Disease Management as necessaryCompletes data entry in a timely mannerPrepares and maintains detailed accurate records of all Case Management activities. Reviews and updates claims as requiredProvides feedback to the Director of Health Services, on case management  issues and provider issues. To assist in the development of discharge planning screening criteria for use in the review process to determine the need for post hospital care and evaluate the effectiveness of discharge plansImplements all approved recommendations in the plan of care.  Updates objective and makes new recommendations as the patient progresses, including contact with the patient, physician and other providers of post hospital resources.  Continues case management actives through case closure as appropriate.  The chosen candidate should posses:OB experience Registered Nurse in the state of residency (NY) Strong Computer Proficiency Strong clinical skillsAlso, the chosen candidate is preferred to posses:Pediatrics experience Managed care experience Home Care experience based on OB Case Management experience Certified Case Manager (CCM)UnitedHealth Group offers a full range of comprehensive benefits to full-time and part-time employees, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan.   UnitedHealth Group is a drug-free workplace.  Candidates are required to pass a drug test before beginning employment   Diversity creates a healthier atmosphere:  equal opportunity employer M/F/D/V.