CFSP Lead OB Specialty Care Manager RN (DSS Region 4)

CFSP Lead OB Specialty Care Manager RN (DSS Region 4)

We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support Medicaid-enrolled infants, children, youth, young adults, and families served by the child welfare system so that they receive seamless, integrated, and coordinated health care. Within the Children and Families Specialty Plan (CFSP), and regardless of where a member lives, they will have access to the same basic benefits and services, including Physical health, Behavioral health, Pharmacy, Intellectual/Developmental Disabilities (I/DD) services, long term services and supports, Unmet health-related resource needs, and Integrated care management. We envision a North Carolina where all children and families thrive in safe, stable, and nurturing homes.

North Carolina residency is required!

$3,500 SIGN ON BONUS

LOCATION: This position supports DSS Region 4. You must live in this region.

HOURS: General business hours, Monday through Friday.

TRAVEL: Some travel within this region is required. When you are not in the field, you will work virtually from your home.

This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Lead OB Specialty Care Manager RN is responsible for coordinating operations and workflows related to OB and Mother/Baby case management activities in support of the North Carolina Foster Care program (CFSP). Manages overall healthcare costs for the foster care population via integrated (physical health/behavioral health/SDOH) case management and whole person health. Manages the most complex cases and provides support to case managers and care coordinators. Performs case management telephonically or in-person visits to members in their homes/care facility.

Primary duties may include, but are not limited to:

• Conducts specialized assessments to identify individual needs, as related to OB and associated health concerns including preventative screenings.
• Develops comprehensive care plan to address objectives and goals as identified during assessment.
• Supports member access to appropriate quality and cost-effective care and modifies plan(s) as needed.
• Coordinates with internal and external resources to meet identified needs of the member in terms of integrated (physical and behavioral) whole person care.
• Coordinates social determinants of health to meet the needs of the member and child, and incorporates the mother/baby planning into care planning.
• Works closely with various state agencies.
• Maintains knowledge of the system of care philosophy; a spectrum of effective, community-based services and supports for those with or at risk for comorbidities related to OB and/or other challenges related to OB, that is organized into a coordinated network.
• Builds meaningful partnerships with designated populations and their families, and addresses cultural and linguistic needs, in order to help them function better at home, in the community, and throughout life.
• Provides important information including patient education of maternal/child as well as routine health, medication reconciliation, and identification of community resources and assists with arrangement of follow-up care.
• Facilitates health rounds with other clinical centered professionals to ensure whole person health.
• May lead and work on specialty projects and initiatives. Assists with process improvements activities.
• Trains and mentors staff.

For the State of North Carolina, in accordance with federal/state law, scope of practice regulations or contract, the requirements are:

• Requires a degree in nursing and minimum of 7 years of clinical experience; or any combination of education and experience which would provide an equivalent background.
• Requires an active, current and valid license as an RN to practice as a health professional within the scope of licensure in the state of North Carolina
• Requires demonstrated experience in Maternal/Child setting with knowledge of OB/GYN assessments and plans of care.

Preferred Qualifications:

• Experience working with high-risk and/or foster care populations is strongly preferred.
• Experience working in an MCO environment is preferred.
• Experience in a Case/Care Management setting is preferred.

Job Level: Non-Management Exempt

Workshift: 1st Shift (United States of America)

Job Family: MED > Licensed/Certified Behavioral Health Role