Manager, Maternal Health (Hybrid)

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:

• Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week

• Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week

• Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month

• Onsite: daily onsite requirement based on the essential functions of the job

• Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.

This position is hybrid within the state of AZ only. This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona.

PURPOSE OF THE JOB

The Manager of Maternal Health provides strategic, operational, and clinical leadership for maternal health programs serving the Medicaid population. This role is accountable for ensuring member access to timely prenatal and postpartum care; promoting family planning and preventive services; improving quality outcomes; and ensuring effective coordination of care across providers, community partners, and internal teams.

QUALIFICATIONS

REQUIRED QUALIFICATIONS

Required Work Experience

• 5 years of experience in clinical care
• 5 years of experience with the maternal health population
• 3 years of prior supervisory and/or management experience

Required Education

• High School Diploma or GED in general field of study

Required Licenses

• Active, current, and unrestricted license to practice in the State of Arizona (a state in the United States) as a Registered Nurse (RN), physician or physician's assistant

Required Certifications

• Once they have directly supervised the integrated care process within (3) years with the organization, hold a certification in case management from the following certifications; Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC)

PREFERRED QUALIFICATIONS

Preferred Work Experience

• Care management experience
• Health plan experience
• Behavioral health experience
• Program development experience
• Knowledge of NCQA and/or URAC health plan standards, AHCCCS, and CMS regulatory requirements

Preferred Education

• Bachelor's or master's degree in nursing or healthcare related field.

Preferred Licenses

• N/A

Preferred Certifications

• N/A

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES

• Provide strategic, operational, and clinical leadership for maternal health programs serving the Medicaid population.
• Lead the day-to-day operations of the maternal health team, including staffing, coaching, performance management, and professional development.
• Foster a positive, collaborative, and inclusive team environment that promotes engagement, accountability, and high performance.
• Oversee maternal health program operations, including:
• Identification and outreach to pregnant members
• Pre-authorization of maternity services
• Care management for high-risk pregnant and postpartum members
• Transition