Women & Children’s Health Outcomes Specialist I

Job description

Job Summary: The Women & Children’s Health Outcomes Specialist is responsible to execute quality monitoring reviews as defined by provider agreement to ensure at-risk pregnant members receive enhanced maternal care as outlined by the Ohio Department of Medicaid to drive improved birth outcomes. Essential Functions: - Receive and input pregnancy risk assessment screenings into Nurture 2.0 and Guiding Care - Review, identify and analyze Pregnancy Risk Assessments for completion, accuracy and trends to drive strategies to improve health outcomes for high-risk pregnant members, including partnering with community and health partners. - Telephonic outreach to members for identified needs that place the members at risk for health, safety and welfare. - Facilitate coordination of member care as initial point-of-contact for pregnant members, ensuring primary care physicians, OB providers, community agencies, transportation, and other partners to ensure member barriers to care are minimized - Collaboration with Women & Children’s Health Manager and/or High-Risk OB team identify populations within CareSource membership that would benefit from focused High Risk OB care coordination - Verify e...