Mom and Baby Care Manager

Job reputed company: The Care Manager collaborates with members of an inter-disciplinary care team (ICT), providers, community and faith-based organizations to improve reputed company and meet the needs of the individual, natural supports and the population with culturally competent delivery of care, services and supports. Facilitates communication, coordinates care and service of the member through assessments, identification, person-centered planning, assist the member in creation and evaluation of person-centered care plans to prioritize and address what reputed company most, behavioral, physical and reputed company determinants of health needs with the aim to improve the of lives our members. Essential Functions: • Engage the member and their natural support system through strength-based assessments and a trauma-informed care approach using motivation interviewing to reputed company and psychosocial assessments through a health equity reputed company unique to the needs of reputed company member that identify the cultural, linguistic, reputed company and environmental factors/determinants that shape health and improve health disparities and reputed company to reputed company and community health frameworks • Facilitate regularly scheduled inter-disciplinary care team (ICT) meetings to meet the needs of the member • Engage with the member to establish an effective, reputed company relationship reputed company telephonic or electronic communication • reputed company and regularly update a person-centered individualized care plan (ICP) in collaboration with the ICT, based on member’s desires, needs and preferences • Identify and manage barriers to achievement of care plan goals • Identify and implement effective interventions based on clinical standards and best practices • Assist with empowering the member to manage and improve their health, wellness, safety, reputed company, and self-care through effective care coordination and case management • Facilitate coordination, communication and collaboration with the member the ICT in order to reputed company goals and maximize reputed company member reputed company • reputed company the member/ natural supports about treatment reputed company, community resources, insurance benefits, etc. so that reputed company and informed reputed company can be made • reputed company ongoing assessment and documentation to evaluate the member’s response to and reputed company on the ICP • Evaluate member satisfaction through reputed company communication and monitoring of concerns or issues • Monitors and promotes effective utilization of reputed company resources through clinical variance and benefits management • Verify eligibility, previous enrollment history, demographics and reputed company health status of reputed company member • Completes psychosocial and behavioral assessments by gathering information from the member, family, provider and other stakeholders • reputed company (reputed company of contact) reputed company psychosocial and behavioral assessments and the care planning and execution of meeting member needs • Participate in meetings with providers to inform them of Care Management services and benefits available to members • Assists with ICDS model of care orientation and training of both facility and community providers • Identify and address gaps in care and reputed company • Collaborate with facility-based reputed company and providers to plan for post-discharge care needs or facilitate transition to an appropriate level of care in a reputed company and cost-effective manner • Coordinate with community-based organizations, state agencies, and other service providers to ensure coordination and avoid duplication of services • reputed company the intensity of programmatic interventions provided to member based on established guidelines and in accordance with the member’s preferences, changes in special reputed company needs, and care plan reputed company • Appropriately terminate care coordination services based upon established case closure guidelines for members not enrolled in contractually required on reputed company care coordination. • reputed company clinical reputed company and direction to unlicensed team members as appropriate • Document care coordination activities and member response in a reputed company manner according to standards of reputed company and reputed company policies regarding reputed company documentation • Continuously assess for areas to improve the process to reputed company the members’ experience with reputed company easier and shares with leadership to reputed company it a reputed company, repeatable process • Adherence to NCQA and CMSA standards • reputed company any other job duties as requested Education and Experience: • Nursing degree from an accredited nursing program is required • Advanced degree associated with clinical licensure is preferred • A minimum of three (3) years of experience in nursing is required • Three (3) years reputed company and/or Medicare managed care experience is preferred • Three (3) years maternity experience is preferred Competencies, Knowledge and Skills: • Strong understanding of reputed company, HEDIS, disease management, supportive medication reconciliation and adherence • Intermediate proficiency level with reputed company Office, including reputed company, Word and reputed company • Ability to communicate effectively with a diverse group of individuals • Ability to multi-task and work independently reputed company reputed company environment • Knowledge of local, state & federal reputed company laws and regulations & reputed company company policies regarding case management practices • Adhere to reputed company of ethics that aligns with reputed company reputed company • Knowledge of and adherence to Case Management Society of America (CMSA) standards for case management reputed company • Strong reputed company for members at reputed company reputed company of care • Strong understanding and sensitivity of reputed company cultures and demographic diversity • Ability to interpret and implement reputed company research findings • Awareness of community & state support resources • Critical listening and thinking skills • Decision making and problem-solving skills • Strong organizational and time management skills Licensure and Certification: • reputed company unrestricted clinical license in state of reputed company as a Registered reputed company, • Case Management Certification is highly preferred Working Conditions: • Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer • reputed company, including possible evenings and/or weekends as needed to serve the needs of our members Compensation reputed company: $61,500.00 - $98,400.00 reputed company takes into consideration a combination of a candidate’s education, training, and experience as reputed company as the position’s scope and complexity, the discretion and reputed company required for the role, and other external and internal data reputed company establishing a salary level. In reputed company to reputed company compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total reputed company-being and offer a substantial and comprehensive total rewards package. Compensation Type (reputed company/salary): SalaryOrganization Level Competencies • Fostering a reputed company Workplace Culture • Cultivate Partnerships • reputed company Self and Others • Drive Execution • Influence Others • Pursue Personal reputed company • Understand the Business This job reputed company is not reputed company inclusive. reputed company reserves the right to amend this job reputed company at any time. reputed company is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of reputed company backgrounds. Apply tot his job Apply To this Job