Ob Case Manager

An employee in this classification serves as the program coordinator for the Pregnancy Care Management (PCM) program. The OB Care Manager provides management services to Medicaid patients at risk for poor pregnancy outcomes. Work is performed under general supervision and is evaluated on the basis of attainment of individual and departmental performance objectives, feedback from the public served, and observation.

• Assess clinical and social stability, ability to impact, and patient willingness to participate in program.

• · Conducts a thorough assessment by review of claims history and medical record, patient interview, case review with prenatal care provider and other methods, on all recipients with one or more priority risk factors on initial or follow-up risk screenings and all recipients directly referred for care management support.

• · Assigns goals, interventions and tasks; reevaluate and update according to program guidelines.

• · Determines follow-up/monitoring frequency and assign care management status (level of intensity); reevaluate and update according to program guidelines.

• · Documents all continued care management activities, interventions, tasks, progress toward goals, etc., in Virtual Health.

• · Performs regular periodic status and goal reviews in Virtual Health at intervals, per program guidelines and as needed, for patients being care managed at all intensity levels.

• · Identifies local community resources available to meet the specific needs of the population.

• · Refers clients to childbirth education, parenting classes, breast feeding support, oral health, behavioral health or other needed services reimbursed by Medicaid.

• · Refers to other supportive services and classes as available in the community.

• · Assess each client and follow-up on compliance with prenatal care issues and other needed clinical services.

• · Contact client’s Pregnancy Medical Home and other appropriate providers to inform them of changes in status and compliance with care.

• · Provides education and assists the client with scheduling a postpartum visit.

• · Provides education concerning the importance of a primary care medical home for clients who continue to remain and/or become eligible for Medicaid beyond the postpartum period and refer them to a primary care medical home of their choice.

• · Attends scheduled PCM Program meetings, webinars and training.

• · Reviews all initial and follow-up pregnancy risk screenings received and ensure they are entered into Virtual Health within 7 days of receipt.

• · Utilizes risk screening data and provider referrals to develop strategies to meet the needs

• of those patients at highest risk for poor pregnancy outcome.

• · Completes Comprehensive Pregnancy Assessment within 30 days of entering client into PCM services.

• · Participates in mass immunization clinics; enters immunizations given into NCIR.

• · Participates in shelter rotation and recovery during hurricanes and other natural disasters.

• · Makes the Nursing Supervisor or Director of Nursing aware of any problems in clinic management and offer recommendations.

• · Performs related duties as required and may include participation in medical record audit reviews, educational in-service programs, professional development and training exercises.

• · Position will be responsible for other duties as assigned. Duties may also include Preparedness activities/directives as assigned by Supervisor, Nursing Director or Agency Director.

• Thorough knowledge of the methods, procedures and policies of Bladen County Health Department as they pertain to the performance of duties of the OB Case Manager.

• · Thorough knowledge of the laws, ordinances, standards and regulations pertaining to the specific duties and responsibilities of the position.

• · Thorough knowledge of and skill in professional nursing theory and practice; has considerable knowledge of the principles and practices of public health nursing and patient care services, including clinic services and home services; has thorough knowledge of the principles and methods of social work; has considerable knowledge of medical terminology, clinic routine and equipment; has considerable knowledge of septic techniques and…