This position is responsible for improving birth outcomes in the Medicaid population. The employee works directly with these women to address social and medical needs that could adversely affect their pregnancy. Collaboration with medical providers and other agencies provides a team approach to identify and meet the needs of pregnant women, to remove barriers to service and to prevent family dysfunction that often leads to major problems such as high risk pregnancies and child abuse and neglect. Work is performed under the supervision of the PHN Supervisor I. Provides follow up and monitoring to ensure that the treatment plan has a positive impact on the client. Monitoring is required to ensure that the treatment plan has a positive impact on the client. Close monitoring may lead to changes in the initial plan as the care manager helps the client adjust to changes in the environment, family and medical situation. The initial assessment aids the care manager in determining the client/family service needs which might include psychosocial, nutritional, medical, education
and financial factors. Skills in coordination and referral are required in order to assist the client in arranging for appropriate services and to ensure continuity of care. Educates and informs the client of needed services and strategies for accessing necessary resources. Educates client in preparation for childbirth and parenting. Encourages families to participate in care coordination services to secure the best possible health and development outcomes. Assess and evaluate the following high risk conditions: hypertension, preeclampsia, diabetes, suspected fetal growth retardation. Administer 17p weekly to clients placed on bed rest that are unable to go to the OB provider. Home visit postpartum clients to provide assessment and teaching after the birth of a newborn. Make referrals as needed Obtain the delivery information from the local hospitals.