Nurse Case Manager

Nurse Case Manager

Job Description

Description:

The goal of this program is to help pregnant and postpartum women with substance use disorder (SUD) access comprehensive and coordinated care, achieve sustained recovery while simultaneously reducing effects of neonatal abstinence syndrome in infants.

Essential Duties /Responsibilities:

Maintain a caseload of pregnant and postpartum women impacted by substance use disorders (SUD) and their infants, primarily composed of individuals receiving Medicaid Fee for Service benefits
Complete outreach, assessments, care planning, case management and care coordination activities for each enrollee as outlined in the Pregnancy Promise Program manual, beginning in the prenatal period and extending through 12-months postpartum
Document and accurately report individual participant data at point of care
Collaborate with medical providers, SUD treatment providers, behavioral health providers and family support providers on behalf of each enrollee and their infant
Perform regular screenings for unmet health-related social needs and make appropriate referrals
Collaborate with Indiana 211 for members who are not eligible for the program or decline enrollment
Respond to email, phone, and text communications from Pregnancy Promise Program enrollees and other providers to answer questions and provide program guidance within 2 business days
Attend IU ECHO sessions on the topics of Treatment for Substance Use Disorders In Pregnancy
Attend FSSA Pregnancy Promise Program weekly team meetings
Attend monthly Pregnancy Promise Program case manager meetings with the Medicaid Health Plans
Participate in the development and revision of program materials and statewide outreach activities
Assist with developing and presenting Pregnancy Promise Program presentations for key stakeholders
Ability to resolve issues with professionalism and sensitivity; must work well with other client and divisions
Ability to use standard computer word processing, spreadsheet and database programs
Ability to compile, synthesize, and present complex recommendations; and
Passion for public service

Job Requirements:

Must be an LPN, RN with a minimum of 2-3 years experience with OB population or SUD treatment
Knowledge of state and federal laws, regulations, and policies related to addiction treatment
Ability to identify, analyze, summarize, and communicate information and to formulate recommendations as needed
Ability to communicate effectively, both orally and in writing
Ability to work effectively with a wide variety of stakeholders including individuals with lived experience, family members, advocates, and providers of mental health and/or addiction services
Knowledge of planning, program development and evaluation methods
Flexible, creative, assertive and able to work in a multiple task and multidisciplinary environment
Must have expertise in working with culturally diverse, at-risk populations
Extensive understanding of Medicaid, waiver services, and managed care.
Extensive knowledge of state laws, policies and procedures pertinent to the Medicaid programs
Knowledge of care coordination and case management (prior experience preferred)


Difficulty of Work:
Work is complex in nature and involves the integration of diverse programs and policies among numerous federal and state agencies as well as a thorough understanding of legal, political, social justice, child welfare, medical and behavioral health parity and equity issues and organizational issues. This position involves an unprecedented level of coordination and integration among various programs impacting maternal and infant health within FSSA, but also other client, including the client. The nature of the grant is new; therefore, the position requires innovative thinking to solve new and complex problems. Must use own initiative and creativity in designing methods and means of performing job duties. Must consider and balance the various issues presented, including the long-term goals of the program, managed care principles, political climate, existing policies and pertinent laws, wavier, rules and regulations. Must have knowledge of evidence-based and promising practices as it relates to pregnant women with OUD and infants with neonatal abstinence syndrome. Must be knowledgeable of home visitation programs, case management competencies and engage in understanding implicit bias, ethics and boundaries and creation of individualized care plans to improve outcomes for enrollees. Must be willing to engage in implementation science framework for plan, do, study, act quality improvement/system building processes. Work is both strategic and tactical in nature, which will require flexibility and creativity to set guidelines and priorities as needed to maintain operations. Position must be able to resolve conflicts between various partners sometimes in an adversarial environment.


Responsibility:
While working with the Project Manager, the Project Specialist, and client leads, the case manager must be able to perform their duties with a high degree of independence with general guidance; new situations will be discussed as needed. Work is reviewed for attainment of project and agency goals and objectives and over all compliance with federal and state requirements. Must be able to formulate solutions to problems and confer with supervisor on high complex and sensitive projects. Implementation of inappropriate or faulty recommendations would cause damage to Medicaid members, the Pregnancy Promise Program, the clientcredibility, or could result in loss of federal funding.

Personal Work Relationships:

Work relationships are with supervisor, project specialist, other OMPP staff, and other FSSA employees across divisions, State Department of Health staff, contractors, Federal and State officials, health organizations and the public for the purpose of coordinating the program, sharing information and assistance in resolving program issues.

Physical Effort:

No unusual physical effort is required. May be required to carry or lift up to 10 lbs., occasionally. Will be required to type/use a computer for extended periods of time. The position is expected to attend meetings in various locations throughout government center and attend scheduled meetings at off-site locations throughout the client.

Working Conditions:

Standard office environment. Some in-state travel required for attending meetings or public speaking engagements. The nature of this position may require extended commitment of time beyond the standard workday during high-volume seasons/operations.



Skill - Required / Desired - Amount of Experience
LPN or RN with current unencumbered IN license. - Required - 2 Years
Minimum of 2-3 years experience with OB population or substance use disorder (SUD) treatment. - Required - 2 Years
Experience with care coordination and case management. - Required - 2 Years
Extensive understanding of Medicaid, waiver services, and managed care. - Required - 2 Years
Familiarity with evidence-based practices for treating pregnant women with Opioid Use Disorder (OUD) and infants with Neonatal Abstinence Syndrome (NA - Required - 2 Years
Knowledge of state and federal laws, regulations, and policies related to addiction treatment. - Required
Knowledge of planning, program development, and evaluation methods. - Required
Proficiency in standard computer word processing, spreadsheet, and database programs. - Required
Strong analytical and problem-solving skills with the ability to communicate effectively both orally and in writing. - Required

VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status