Maternity Care Navigator

CareSource Management Services; Florida; Hybrid; USD 47,000 - 76,000; Full time

Job summary

CareSource Management Services in the United States is seeking a Maternity Care Coordinator to serve as the member concierge and single point of contact for assessment, planning, and service coordination in the Mom and Baby Beginnings program.

The role involves telephonic enrollment, health and psychosocial surveys, education on the program, initial screening, eligibility verification, and timely documentation, while building strong member relationships and collaborating with physicians to

Qualifications

• 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

Responsibilities

• 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 CareSource policies regarding professional documentation
• Look for ways to improve the process to make the members experience with CareSource 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

Skills

Microsoft Office

Outlook

Word

Excel

Effective communication

Multi-tasking

Regulatory knowledge

CMSA standards

Member advocacy

Cultural competence

Research literacy

Community resources

Active listening

Decision making

Time management

Trauma-informed

Education

Diploma or Associates in healthcare

Bachelor's degree in healthcare

Job description

CareSource Management Services in the United States is seeking a Maternity Care Coordinator to serve as the member concierge and single point of contact for assessment, planning, and service coordination in the Mom and Baby Beginnings program.

The role involves telephonic enrollment, health and psychosocial surveys, education on the program, initial screening, eligibility verification, and timely documentation, while building strong member relationships and collaborating with physicians to