Women & Children’s Health Outcomes Specialist I

📋 Description

• • The Women & Children’s Health Outcomes Specialist I is responsible for executing quality monitoring reviews to ensure at-risk pregnant members receive enhanced maternal care as outlined by the Ohio Department of Medicaid, driving improved birth outcomes.
• • Day-to-day responsibilities include receiving and inputting pregnancy risk assessment screenings into Nurture 2.0 and Guiding Care, reviewing and analyzing assessments for accuracy and trends, conducting telephonic outreach to members with identified risks, facilitating care coordination with providers and community agencies, verifying member eligibility and health status, and contributing to assessments by gathering information from members, families, and providers.
• • The role is part of CareSource Management Group Company, a mission-driven organization focused on improving health outcomes for vulnerable populations, particularly women and children, through coordinated care and community partnerships.
• • In this role, the individual will develop expertise in maternal and child health programs, strengthen skills in case management and utilization review, gain experience with healthcare regulations and data systems, and contribute directly to reducing health disparities and improving birth outcomes for high-risk pregnant members.