Job Description
About the position We are looking for an Infertility/Maternity Nurse Care Manager for our Care and Case Management team who also holds a CCM and a CA license. You must have case and disease management in a health plan, health navigator or third-party administrator (TPA) environment. You must be passionate about holistic, patient-centered care to support members through their healthcare journey and ensure needs are met with industry-leading interventions. As a telephonic Nurse Care Manager you will specialize in guiding members through both routine and complex infertility and maternity clinical scenarios.
You will report to the Manager, Care and Case Management and partner with a diverse clinical team, including providers, care coordinators, and other supporting team members, to deliver integrated remote care and case management. You should enjoy spending time on the phone, listening to members' needs, answering questions, and serving as a member advocate. You will excel at creating personalized care plans and have the clinical skills to guide members through infertility and maternity journeys, while navigating available benefits and resources.
As a CCM-certified nurse, you will be equipped with the expertise to navigate complex healthcare systems and ensure that each member receives the highest quality care. Nurse Care Managers will support members with education, advocacy, and care management through family-building/fertility journeys and prenatal/postpartum care, ensuring they receive comprehensive care that results in positive health outcomes for both them and their families. Responsibilities • Deliver coordinated, patient-centered virtual Care Management by telephone or messaging that improves members' health outcomes.
• Create impactful care plans together with members and our diverse care team, and help members achieve their desired goals. • Help members navigate complex medical conditions, treatment pathways, benefits, and the healthcare system in general. • Partner with the members' local providers to ensure coordinated care. • Provide compassionate, longitudinal follow-up care, building supportive relationships. Requirements • Bachelor of Science in Nursing (BSN). • Must reside in a compact NLC state. • Active Compact RN license in good standing with the nursing board of their state.
• Active California Nursing License required. • Willingness to become licensed in multiple states. • Must have current CCM Certification or eligibility to sit exam in August 2025. • 3 years of experience in nursing. • 2+ years experience working in care, case and disease management. • 2+ years experience working in labor and delivery. • 2+ years experience working in infertility. • Be comfortable discussing different medical conditions. • Spanish speaking desirable. • Experience with technology and an understanding of digital tools and EMR platforms.
• Strong empathy and commitment to patient-centered care. • Meet volume goals while maintaining quality standards. • Flexibility and comfort in an evolving environment. • Strictly follow security and HIPAA regulations to protect our patients' medical information. • Be pleasant, responsive, and willing to work with and learn from our team. • Strong competence and ability to use multiple computer/medical record systems. • Collaborate well across diverse teams with clinical and non-clinical members to deliver a seamless, top-quality care experience to patients.
• Understand cultural and socioeconomic issues affecting members and to coordinate all available resources to serve members. • Translate medical information into clear, accessible, and patient-friendly language. • Strict adherence to security and HIPAA regulations. Benefits • Remote-first culture. • 401(k) savings plan through Fidelity. • Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance). • Paid Time Off ('PTO') and Discretionary Time Off ('DTO').
• 12 weeks of 100% Paid Parental leave. • Family Building & Compassionate Leave: Fertility coverage, $25,000 for surrogacy/adoption, and paid leave for failed treatments, adoption or pregnancies. • Work-From-Home reimbursement to support team collaboration home office work. Apply tot his job