Public Health Nurse II (High Risk Pregnancy Care Manager)
SALARY: “Based on Nursing Education Degree and Public Health Nursing Experience”
OPENING DATE: August 19, 2019 “OPEN UNTIL FILLED”
APPLY AT: Duplin County Personnel Office
County Administration Building
224 Seminary Street
Kenansville, NC 28349
“Equal Opportunity Employer”
General Description of Duties
The primary purpose of this position is to provide Care Management for High-Risk Pregnancy (CMHRP) to Medicaid pregnant women. A high level of nursing skill is required to provide case management and determine the appropriate interventions. This employee must stay current and have a working knowledge of standing orders, child health, adult health, family planning, maternal health, STD, TB, communicable disease, immunizations and abnormal pap smear guidelines. This employee must stay current on case management, assessment & referral, supportive counseling & intervention, psycho-social therapy and treatment planning.
Specific Duties and Responsibilities
90% Care Management for High-Risk Pregnancy (CMHRP)
-Refer potentially Medicaid-eligible pregnant women to prenatal care and Medicaid eligibility determination.
-Make timely attempts, following standards outlined in the CMHRP Standardized Plan to contact patient to engage the patient in care management services.
-Develop and utilize motivational interviewing techniques when attempting to engage patient and on an ongoing basis.
-Contact patients identified as having a priority risk factor through claims data (Emergency Department utilization, ante partum hospitalization, utilization of Labor & Delivery triage unit) for referral to prenatal care and assess for care management need.
-Review and enter into Virtual Health, Pregnancy Risk Screening Forms received from Pregnancy Medical Homes (PMH) for women eligible for Medicaid within seven calendar days of receipt of risk screening forms.
-Utilize risk screening data and provider referrals to develop strategies to meet the needs of those patients at highest risk for poor pregnancy outcome.
-Accept pregnancy care management referrals from non-PMH prenatal care providers, community referral sources, (such as WIC and DSS), and patient self-referral, and provide appropriate assessment and follow up to those patients based on the level of need.
-Conduct a prompt and thorough assessment by review of claims history and medical record, patient interview, case review with prenatal care provider and other methods, on all patients who have a Maternal Infant Impact Score (MIIS) over 200 and all patients directly referred for care management to determine level of care management support needs.
-Utilize assessment findings to determine level of need for care management support. Document assessment findings in Virtual Health.
-Assessment documentation must be current throughout the period of time the care manager is working with patient and should be continually updated as new information is obtained.
-Assign case statues as outlined according to program guidelines, based on level of patient need.
-Provide care management services in accordance with program guidelines, including condition-specific pathways, utilizing those interventions that are most effective in engaging patients and meeting their needs, including telephone outreach, practice encounters, home visits, and interventions needed to achieve care plan goals.
-Collaborate with out of county PMHs and CMHRP teams to facilitate cross county partnerships to ensure coordination of care and appropriate Pregnancy Care Management assessment and services for all patients in the priority population.
-Provide care management services based upon level of need as determined through ongoing assessment of the patient.
-Develop patient-centered care plans including appropriate goals, interventions and tasks based on CMHRP guidance, CMHRP standardized plan, CMHRP Pathways, Virtual Health Step-by-Step Documentation Guide for CMHRP.
-Maintain regular collaboration and communication with the prenatal care provider and other clinical providers. Document interactions with all care providers in Virtual Health.
-Identify community resources available to meet the specific needs of the population.
-Refer identified population to childbirth education, WIC, oral health, behavioral health or other needed services reimbursed by Medicaid.
-Refer identified population to community resources including: lactation, parenting, and other supportive services and classes as available in the community.
-Establish a cooperative working relationship and mutually-agreeable methods of patient-specific and other ongoing communication with each PMH.
-Establish effective communication strategies with PMH providers and other key contacts within the practice for each PMH within the county or serving residents of the county.
-Assigned care manager participants in relevant PMH meetings addressing care of patients in the target population.
-Assess and follow-up on compliance with prenatal care plan and other needed clinical services.
-Ensure changes in status and compliance with care are communicated to the PMH and other appropriate providers.
-Provide education about the importance a postpartum visit. Assist with the scheduling of postpartum visits. Document completed postpartum visits in Virtual Health.
-Support 17P treatment through regular outreach and education to patients on 17P treatment and assist patients in arranging to receive 17P injections in accordance with best practices. Complete the 17P assessment in Virtual Health on a weekly basis.
-Arrange transition from the PMH to a primary care medical home for patients who continue to remain and/or become eligible for Medicaid beyond the postpartum period.
-Maintain regular collaboration and communication with the prenatal care provider and other clinical providers. Document interaction with all care providers in Virtual Health.
-Communicate with Supervisor regarding challenges in collaboration with PMH and non-PMH prenatal care providers.
-Pregnancy care managers shall attend pregnancy care management training offered by the Division of Public Health and /or appropriate entities including webinars and new hire orientation.
-Pregnancy care managers will attend continuing education sessions coordinated by the Division of Public Health and/or other appropriate entities including program meetings, regional trainings and state wide conferences.
-Pregnancy care managers shall pursue ongoing continuing education opportunities to stay current in evidence–based care management of pregnant and postpartum women at risk for poor birth outcomes.
Minimum Training and Experience
Graduation from a four-year college or university with a BS Degree in Nursing which includes a Public Health Nursing rotation; or Graduation from an accredited school of professional nursing and one year of professional nursing experience; or An equivalent combination of education and experience.
Must be or become certified in basic CPR life support; Valid, current NC driver’s license; Reliable means of transportation; Introduction to Principles and Practices of Public Health Nursing; Experience in pediatrics, maternity, family planning, and adult health nursing.