Pop Health Concierge Care Coordination RN- Medical Pediatric Pop
$75,000–$85,000 year
On-siteSunrise, Florida, United States
Job Summary
Coordinate maternal and child health care for pediatric members, conducting intake assessments, developing individualized care plans, and managing interventions across the continuum of care. Facilitate safe levels of care by reducing unnecessary C-sections and NICU admissions while closing immediate care gaps and empowering members to self-manage chronic conditions. Provide routine follow-up, ensure appointment compliance, and link enrollees to primary care, community resources, and specialized screenings for HIV, Hepatitis B, and other requirements. Monitor clinical outcomes, evaluate treatment plans, and refer patients to contracted providers or external agencies as needed.
Required Qualifications
- 2 years prior experience working with pediatric populations
- Bachelor's Degree in Nursing
- Registered Nurse licensure in the state of Florida
- 3-5 years of clinical experience including labor and delivery, high risk antepartum and NICU
- 3-5 years of experience in a managed care, health plan, or insurance setting, particularly in maternal health or disease/case management roles
- Experience coordinating care across medical, maternal/child, and social service providers, including familiarity with utilization management processes, appeals, and authorizations
- Experience working with Medicaid, Medicare, or other state and federal health care programs, including knowledge of relevant regulations and compliance requirements
- Knowledge of Microsoft Office and internet software
- Strong understanding of maternal and child health, including high-risk pregnancy management, prenatal and postnatal care, and common complications
- Knowledge of evidence-based practices and guidelines in maternal and child health, including breastfeeding promotion, nutritional assessments, and preventive screenings
- Proven ability to coordinate care across multiple providers and settings, ensuring seamless integration of services for mothers and newborns
- Experience in developing individualized care plans, monitoring progress, and adjusting care strategies as needed
- Proficient in assessing and managing the psychosocial, educational, and medical needs of pregnant members and their newborns
- Exceptional oral and written communication skills, including the ability to effectively engage and educate enrollees, families, and healthcare providers
- Strong interpersonal skills with the ability to build and maintain effective, professional relationships with enrollees, care teams, and community resources
- Ability to speak effectively before groups, including enrollees, healthcare professionals, and community stakeholders
- Demonstrated ability to assess complex situations, identify barriers to care, and develop creative solutions to improve health outcomes
- Strong analytical skills to evaluate data, track clinical outcomes, and implement care strategies that reduce risks and enhance patient care
- Must complete a Level 2 background screening through the Florida Care Provider Background Screening Clearinghouse
Desired Qualifications
- Master's Degree in Nursing
- Certified Case Manager
- Knowledge of EPIC and/or JIVA
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