Find The RightJob.

RN - Registered Nurse, High Risk Maternity

Location : This position is located at our Dublin, OH campus with hybrid flexibility. Who we are Founded in 1999 and headquartered in Central Ohio, w e’re a privately-owned , independent healthcare navigation organization . We believe that no one should have to navigate the cost and complexity of healthcare alon e, and w e’re on a mission to make healthcare simpler and more effective for our millions of members . Our big-hearted, tech-savvy team fight s to ensure that our members get the care they need, when they need it, at the most affordable cost – that’s why we call ourselves Healthcare Warriors®. We’re committed to building diverse and inclusive teams – more than 2,000 of us and counting – so if you’re excited about this position, we encourage you to apply – even if your experience doesn’t match every requirement. About the role The Personal Care Guide Nurse – High Risk Maternity is responsible for providing case management services for members of Quantum Health employer groups identified with high-risk pregnancies, and families of NICU babies up to one year of life. Upon identification, the High Risk Maternity PCG will outreach to the members to provide support regarding: Benefits and coverage, network steerage, monitoring & management of health symptoms, assistance in understanding and compliance with treatment plan, depression screening, post-delivery care, and any other identified needs through management of each member. They also function as a clinical resource for other staff in the company such as Utilization Management & Patient Services. What you’ll do

Identify members for specific case management activities by utilizing established screening criteria.
Coordinate all services in an effort to provide integrated health services for each member and/or their family.
Apply the nursing process when actively managing members.
Utilize well-developed critical thinking and interpersonal skills to problem solve and make knowledgeable recommendations for needed actions.
Document all activities specific to members, caregivers, providers, facilities and clients in appropriate database.
Maintain a collaborative relationship among health care teams by communicating information, responding to requests, building rapport, participating in team problem-solving methods.
Serve as member and provider advocate by educating and guiding through the complicated healthcare system.
Provide benefit and health information to each member so they are able to make informed health decisions. Promote the mission and core values of Quantum Health.
Assure quality of care by adhering to therapeutic standards; measuring health outcomes against member care goals and standards; following hospital and nursing division's philosophies and standards of care set by state board of nursing, state nurse practice act, and other governing agency regulations.
Maintain a working knowledge of all policies and procedures related to Clinical Operations.
Maintain a working knowledge of employer health benefit plans and know where to access benefit information.
Be a clinical resource for all Quantum Health work teams.
Assist members and clients with wellness activities, enhanced benefits, behavioral incentives.
All other duties as assigned.

What you’ll bring

Active license as a Registered Nurse in the state of Ohio, BSN preferred
Minimum of two years clinical experience with direct patient care required
Minimum of one year experience with Mother/Infant, Labor & Delivery, and/or NICU experience preferred
Possess excellent critical thinking skills
Certification in Case Management preferred
Strong customer service skills
Possess excellent verbal and written communication skills
Possess excellent time management skills
Ability to make decisions that are timely and achieve results consistent with the business goals and organizational culture
Ability to work independently with minimal supervision
Protect and take care of our company and member’s data every day by committing to work within our company ethics and policies.
Strong administrative/technical skills; Comfort working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), IM/video conferencing (Teams & Zoom), and telephones efficiently.
Trustworthy and accountable behavior, capable of viewing and maintaining confidential information daily.