CA Licensed Infertility Maternity Nurse Care Manager, CCM

Infertility/Maternity Nurse Care Manager

Employment Type: Full-time

Position Overview

We are seeking a passionate and skilled Infertility/Maternity Nurse Care Manager to join our Care and Case Management team. This telephonic role specializes in guiding members through routine and complex infertility and maternity clinical scenarios. You will act as a member advocate, providing education, support, and care management throughout their family-building and prenatal/postpartum journeys. The ideal candidate is comfortable with phone-based communication, possesses strong clinical skills, and is dedicated to holistic, patient-centered care.

Responsibilities

• Deliver coordinated, patient-centered virtual Care Management via telephone or messaging to improve member health outcomes.
• Create impactful care plans in collaboration with members and the care team, helping members achieve their goals.
• Assist members in navigating complex medical conditions, treatment pathways, benefits, and the healthcare system.
• Partner with members' local providers to ensure coordinated care.
• Provide compassionate, longitudinal follow-up care, building supportive relationships.
• Educate, advocate, and manage care for members undergoing family-building/fertility journeys and prenatal/postpartum care.
• Ensure members receive comprehensive care for positive health outcomes for themselves and their families.
• Translate medical information into clear, accessible, and patient-friendly language.
• Strictly adhere to security and HIPAA regulations.

Qualifications and Requirements

• Education: Bachelor of Science in Nursing (BSN).
• Licensure:
  • Active Compact RN license in good standing.
  • Active California Nursing License required.
  • Willingness to become licensed in multiple states.
• Certifications: Must have current CCM Certification or be eligible to sit for the exam in August 2025.
• Experience:
  • 3+ years of experience in nursing.
  • 2+ years of experience in care, case, and disease management within a health plan, health navigator, or third-party administrator (TPA) environment.
  • 2+ years of experience in labor and delivery.
  • 2+ years of experience in infertility.
• Skills:
  • Comfortable discussing different medical conditions.
  • Spanish speaking is desirable.
  • Experience with technology, digital tools, and EMR platforms.
  • Strong empathy and commitment to patient-centered care.
  • Ability to meet volume goals while maintaining quality standards.
  • Flexibility and comfort in an evolving environment.
  • Strong competence and ability to use multiple computer/medical record systems.
  • Ability to collaborate well across diverse teams (clinical and non-clinical).
  • Understanding of cultural and socioeconomic issues affecting members.
  • Ability to coordinate all available resources to serve members.

Work Environment

• Must reside in a compact NLC state.
• Telephonic role requiring significant phone and computer usage.

Physical/Cognitive Requirements

• Prompt and regular attendance at assigned work location.
• Capability to remain seated in a stationary position for prolonged periods.
• Eye-hand coordination and manual dexterity to operate keyboard, computer, and other office-related equipment.
• No heavy lifting is expected, though occasional exertion may be required.