Prenatal Care Manager II at Charleston

Job Description

Under the supervision of the Supervisor of Integrated Care Management, the Prenatal Care Manager RN assists members appropriate for care coordination andcare management services in achieving their optimal level of health. The PrenatalCare Manager RN is responsible for engaging the pregnantmember and providers to assess, plan and establish individual member goals. Will facilitate and coordinate care for the pregnantmembers while assuring quality and use of cost-effective resources. The position will function as a single point of contact and be an advocate for pregnant members in the Bright Startcare coordination program.

Principle accountabilities are, but not limited to:

• Assess members to determine care coordination and case management needs for all referred members.
• Completes comprehensive assessment of medical , psycho-social and environmental support needs.
• Identifies problems/barriers for care coordination and appropriate care management interventions.
• Creates a plan of care to assist members in reducing/resolving problems and or barriers so that members may achieve their optimal level of health. Identifies both short and long term goals and associated time frames for completion. Shares goals with the member and family as appropriate.
• Identifies and implements the appropriate level of intervention based upon the members needs and clinical progress. Schedules follow up calls as necessary.
• Implements actions to address member needs. Documents progress towards meeting goals and resolving problems.
• Facilitates access to entitlement programs and or community resources.
• Monitors and documents members on going progress.
• Participates in the discharge planning process for hospitalized members.
• Participates in work groups as requested.
• Maintains confidentiality of all company, provider and member information.
• Identifies and refers potential and actual quality issues to the quality management department.
• Keeps up to date with case management initiatives.
• Attends scheduled meetings.
• Obtains necessary educational requirements to maintain professional licensure and certifications.
• Comply with HIPAA confidentiality requirements to protect member personal identifiable health information.

Position Qualifications/Requirements:

Education and Experience:

• Registered Nurse, with Diploma, Associate or Bachelors degree.
• Bachelors in Nursing preferred
• Experience in Labor and Delivery, Mother / Baby, post-partum care
• Three five years of Case Management experience preferred
• Certification as a case manager preferred.

Licenses, Registrations or Certification:

• Active RN license in the state of South Carolina.
• Valid drivers license with car insurance.
• Obtain Certification in Case Management within two years of accepting position.

Job Requirements

Country: USA, State: South Carolina, City: Charleston, Company: Select Health of South Carolina.