About the Role
Essential Functions:
Telephonically engage and enroll members in Mom and Baby Beginnings program
Engage the member and complete a health and psychosocial survey, taking into account the cultural and linguistic needs of each member
Educate members on the Mom & Baby Beginnings program
Conduct initial screening and needs assessments
Verify eligibility, previous enrollment history, demographics, and current health status of each member
Provide timely and accurate documentation
Build and strengthen member relationships by providing quality customer service
Establish positive, consultative relationships with assigned Physician offices
Document care coordination activities and member response in a timely manner according to standards of practice and policies regarding professional documentation
Look for ways to improve the process to make the members experience with easier and shares with leadership to make it a standard, repeatable process
Work closely with a members’ assigned case manager to coordinate care and programs
Understand and implement Person-Centered Thinking
Facilitate the Person-Centered planning process
Participate in person-centered care training in order to maximize the development of the Person-Centered plan
Coordinate services and health benefits for members who meet criteria
Consult and collaborate with other professionals and community members to coordinate care and develop Person-Centered plans
Ongoing communication with the internal complex clinical team
Monitor service delivery to ensure appropriateness of care and compliance with waiver
Assist Providers with technical questions regarding process
Monitor and evaluate Person-Centered care plan on an ongoing basis through member, family, provider and stakeholder contact by modifying the plan as needed based on member choice
Assist with internal care coordination activities to support member outcomes
Maintain current and accurate documentation of contacts, treatment plans, case notes, referrals, and assessments in the electronic record according to current accreditation and compliance guidelines
Participate in meetings with providers to inform them of services and benefits available to members
May precept and/or mentor new staff
Perform any other job duties as requested
Requirements
Education and Experience:
Diploma or Associates in a healthcare related field or equivalent years of relevant work experience is required
Bachelor’s degree in a healthcare related field is preferred
A minimum of three (3) years of experience in a healthcare field (i.e. discharge planning, case management, care coordination, and/or home/community health management experience) is required
Competencies, Knowledge and Skills:
Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel
Ability to communicate effectively with a diverse group of individuals
Ability to multi-task and work independently within a team environment
Knowledge of local, state & federal healthcare laws and regulations & all company policies regarding case management practices
Knowledge of and adherence to Case Management Society of America (CMSA) standards for case management practice
Strong advocate for members at all levels of care
Strong understanding and respect of all cultures and demographic diversity
Ability to interpret and implement current 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
Trauma informed training
About the Company
RepuCare, a certified Woman Owned Business (WBE) is the driving force behind innovative workforce solutions. We are partnered with a large managed care provider in search of a Maternity Care Coordinator for their team.
The Maternity Care Coordinator is the member concierge and is the single point of contact for assessment, person centered planning, and service coordination for the Mom and Baby Beginnings program