Maternal Child Health Integrated Care Manager
Our Mission: Provide the best value in health insurance and related health services to improve the quality of life for Arizonans.
Inspire health in Arizona as the trusted leader in delivering affordable, innovative healthcare solutions.
Our Benefits: Our benefits provide work-life balance and the flexibility you need to be your best. We offer comprehensive medical, dental, and vision coverage; a 401K savings plan; paid holidays and vacations; and much more!
The Maternal Child Health Integrated Care Manager (MCH ICM) is responsible for identifying and coordinating appropriate physical and behavioral health services for Health Choice Arizona (HCA) members with Serious Mental Illness who are either pregnant/postpartum or 18 to 20 years old with complex needs. Applicant should have knowledge and experience with pregnant women and/or young adults. The MCH ICM provides subject matter expertise, working directly with members and their care teams.
- Ensuring members engage in prevention, prenatal/postpartum visits, EPSDT visits, disease management services, and health promotion activities, consistent with need
- Effectively transitioning members from one level of care to another.
- Reducing hospital admissions and unnecessary emergency department and crisis service use.
- Providing member care teams with the proper tools so members can self-manage care in order to safely live, work, and integrate into the community
- Identifying and transferring important clinical information and test results, such as discharge summaries, critical lab results, medications, emergency room visits, etc.
- Developing, streamlining, monitoring, and adjusting members' Integrated Care Management Plans based on progress and outcomes to include:
- Clinical interventions recommended to the treatment team
- Strategies for successful transitions between levels of care / facilities / providers, discharge planning and coordination of care gaps
- Delineation of responsibilities for involved providers across systems for monitoring referrals and follow-up specialty care
- A schedule for routine health care services, medication monitoring, prevention, EPSDT, disease management, and health promotion activities
- Strategies, such as health coaching and wellness, to facilitate behavior change to address underlying health needs and member self-management
- A review of recent utilization information including inpatient admissions, emergency department visits, and prescription fills
- Care team information to facilitate coordination of care: active providers, their roles, and their contact information
- Participation in the design of integrated health activities and services; promoting HCA integrated programs with network providers and stakeholders, as requested
- Participation in HCA committees, projects, and work teams
- Developing relationships with treatment providers throughout Northern Arizona, including travel for site visits
Education / Experience / Other Requirements
- Current Arizona licensed Registered Nurse (RN) and a minimum of two years' experience
Years of Experience:
- Minimum: two years' direct clinical experience and/or two years’ care management experience
- Preferred: 5 years’ experience
- Knowledge of the Arizona Behavioral Health System and its resources
- Knowledge of the AHCCCS Medicaid system
- Knowledge of the principles and benefits of integrated health care and population health, and / or willingness to learn
- Experience managing complex and unique caseloads for persons with both physical and behavioral health needs
- Experience working in maternal health
Skills & Abilities:
- Skilled at using Microsoft Office applications, especially Excel
- Ability to document activities accurately and timely in an electronic medical record system
- Ability to maintain confidentiality, privacy and security of protected health information and proprietary information
- Ability to communicate professionally in written and oral formats
- Ability to deliver presentations to large groups
- Ability to work effectively in a team model
- Some travel required
- Valid Arizona drivers' license