Maternity Case Manager Jobs in Ohio (NOW HIRING)

Location: This position is located at our Dublin, OH campus with hybrid flexibility. 

Who we are

Founded in 1999 and headquartered in Central Ohio, we're a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we're on a mission to make healthcare simpler and more effective for our millions of members. Our big-hearted, tech-savvy team fights 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; MSL license required within 90 days of employment 
• 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. 

#LI-HW1 #LI-Hybrid

What's in it for you

• Compensation: Competitive base and incentive compensation
• Coverage: Health, vision and dental featuring our best-in-class healthcare navigation services, along with life insurance, legal and identity protection, adoption assistance, EAP, Teladoc services and more.
• Retirement: 401(k) plan with up to 4% employer match and full vesting on day one.
• Balance: Paid Time Off (PTO), 7 paid holidays, parental leave, volunteer days, paid sabbaticals, and more.
• Development: Tuition reimbursement up to $5,250 annually, certification/continuing education reimbursement, discounted higher education partnerships, paid trainings and leadership development.
• Culture: Recognition as a Best Place to Work for 15+ years, dedication to diversity, philanthropy and sustainability, and people-first values that drive every decision.
• Environment: A modern workplace with a casual dress code, open floor plans, full-service dining, free snacks and drinks, complimentary 24/7 fitness center with group classes, outdoor walking paths, game room, notary and dry-cleaning services and more!

What you should know

• Internal Associates: Already a Healthcare Warrior? Apply internally through Jobvite.
• Process: Application > Phone Screen > Online Assessment(s) > Interview(s) > Offer > Background Check.
• Diversity, Equity and Inclusion: Quantum Health welcomes everyone. We value our diverse team and suppliers, we're committed to empowering our ERGs, and we're proud to be an equal opportunity employer .
• Tobacco-Free Campus: To further enable the health and wellbeing of our associates and community, Quantum Health maintains a tobacco-free environment. The use of all types of tobacco products is prohibited in all company facilities and on all company grounds.
• Compensation Ranges: Compensation details published by job boards are estimates and not verified by Quantum Health. Details surrounding compensation will be disclosed throughout the interview process. Compensation offered is based on the candidate's unique combination of experience and qualifications related to the position.
• Sponsorship: Applicants must be legally authorized to work in the United States on a permanent and ongoing future basis without requiring sponsorship.
• Agencies: Quantum Health does not accept unsolicited resumes or outreach from third-parties. Absent a signed MSA and request/approval from Talent Acquisition to submit candidates for a specific requisition, we will not approve payment to any third party.

Reasonable Accommodation: Should you require reasonable accommodation(s) to participate in the application/interview/selection process, or in order to complete the essential duties of the position upon acceptance of a job offer, click here to submit a recruitment accommodation request.

California Employee and Job Applicant Notice of Collection of Personal Information: If you are a California resident, Quantum Health may collect personal information in connection with your application for employment and, if hired, during the course of your employment. The categories of personal information collected and the purposes for which that information is used are described in our California Employee and Job Applicant Notice of Collection of Personal Information. Please review the notice here:
California Employee and Job Applicant Notice

Recruiting Scams: Unfortunately, scams targeting job seekers are common. To protect our candidates, we want to remind you that authorized representatives of Quantum Health will only contact you from an email address ending in @quantum-health.com. Quantum Health will never ask for personally identifiable information such as Date of Birth (DOB), Social Security Number (SSN), banking/direct/tax details, etc. via email or any other non-secure system, nor will we instruct you to make any purchases related to your employment. If you believe you've encountered a recruiting scam, report it to the Federal Trade Commission and your state's Attorney General.