Prenatal Case Manager in Plainsboro, New Jersey at ZUFALL HEALTH CENTER INC

Reporting to the SVP of Nursing and Clinical Operations (SVPNCO) in conjunction with the Director of Prenatal Program and the Prenatal and Post Partum Care Nurse, the Prenatal Case Manager assists prenatal patients and their families in accessing appropriate clinical and social services. The Prenatal Case Manager is a key member of the Care Team and focuses on needs and barriers (such as financial, cultural, language, insurance) that prevent patients from achieving healthy outcomes. Travel is expected to be local with required attendance at some community meetings.

Essential functions, Duties and Responsibilities

• Works as part of the Care Team to identify prenatal patients in need of services and communicates with provider as to progress
• Meets initially with each prenatal patient and follow up visits as required by patient needs or referrals
• Keeps an active problem list and tracks patients that have been referred. Documents level of services provided and discuss with MCHI PC on a weekly basis. Updates Plan of Care as needed
• Follows up on missed appointments and reschedules as appropriate. Contacts prenatal patients that are overdue for visits
• Enters interventions and follow up plans in electronic medical record-eCW
• Assists prenatal patients with arrangements for transportation, translation, and other barriers to attending appointments
• Assists prenatal patients with completion of medical, prescription, service forms and with requests to other providers and agencies
• Assists patients with applications to charity care at Clara Maas Medical Center, Emergency Medicaid and PW Medicaid, NJ Family Care, WIC and other benefits or insurances as appropriate
• Completes PRAspect initial file entry for every patient required by the State of NJ
• Updates PRAspect file as insurance changes from PEPW, Medicaid, HMO, 3rd trimester, and final birth data required for Birth Certificate production
• Facilitates referrals for Zufall Health Center providers to refer prenatal patients into behavioral health and enabling services, including referrals to outside agencies and programs. Facilitates interchange of pertinent clinical information as per HIPAA guidelines to the Care Team and outside providers involved in the care of the patient.
• Facilitates first Newborn visit with Zufall Health Providers
• Identify community resources and services that address barriers encountered by prenatal patients and their families and assist patients in accessing such services
• Acts as advocate for patients and their families with community organizations and other agencies
• Conducts Spanish speaking classes relative to Prenatal patients as trained/directed by Prenatal Coordinator. (Breastfeeding, Labor & Delivery)
• Educates patients on acquiring a Breast pump through Insurance or WIC

• Working knowledge of medical terminology
• Proficient, accurate and detailed documentation
• Excellent knowledge of available community services and resources
• A working knowledge of prenatal care needs and possible barriers
• Excellent communication and interpersonal skills
• Ability to assist patients through adverse pregnancy outcomes with empathy
• Ability to work as part of a care team
• Bilingual English/Spanish required
• Ability to communicate well with patients, staff and outside providers and agencies
• Ability to maintain high level of confidentiality
• Assist supervising/training AmeriCorp members/volunteers
• Working knowledge of Zufall Health Center policies and procedures, mission and values
• Some travel may be required between sites. Valid NJ State Driver’s license in good standing
• Learn and apply the trauma informed care principles with the scope of my position

Education, Training and Experience

• Minimum Bachelor’s Degree with appropriate health and/or social services related experience
• Minimum two years experience in a clinical setting
• Experience working with Medical Insurance- Medicaid, HMO, ACA
• Experience with PRAspect for Medicaid payments and GEMS Authorizations
• Experience working with community service agencies
• Knowledge of Microsoft Office, Excel and use of electronic medical records