What are the responsibilities and job description for the RN CASE MANAGER - HOME VISITING (FULL-TIME) position at Coordinated Youth and Human Services?

DIVERSITY, EQUITY & INCLUSION STATEMENT

CYHS is deeply committed to empowering youth and families to lead fulfilling lives by embracing the ever-changing needs of the community. Creating a diverse workforce is essential in meeting the needs of those we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. We strongly believe creating a diverse workforce will generate new ideas and varied perspectives enabling us to have a greater impact on our community.

POSITION SUMMARY

High Risk Family Case Management (HRFCM) provides nursing assessment, intervention, and service coordination to improve the health, social, educational, and developmental needs of high-risk pregnant & postpartum individuals and / or their high-risk infants throughout pregnancy and the first one year after birth. Nurse case management services will be provided to high-risk birthing families, with the goal of reducing maternal and infant morbidity and mortality rates at both the state and local level with an emphasis on addressing racial / ethnic disparities in outcomes.

CORE ACCOUNTABILITIES

High Risk Family Case Management

To eliminate barriers to client transportation and decrease risk of communicable diseases in the high-risk population, nurse visits will occur exclusively in the home setting monthly for the duration of pregnancy and at least the first three months after birth. The monthly visits during the fourth through twelfth month after birth can occur in the clinic or home setting while family is enrolled in the program based upon family preference.
Offer opportunity for visit outside of the standard schedule to accommodate working families and / or urgent / unexpected needs.
Provide nursing assessments and interventions, screenings, referrals, service coordination, and diagnosis-specific education to improve the health, social, educational, and developmental needs of high-risk dyads (pregnant & postpartum individuals and their infants) throughout pregnancy and the first one year after birth to Illinois residents who meet the eligibility criteria for the program.
Initial phone contact should occur within 7 days of receiving referral. The initial home visit should be completed within 14 days of program enrollment.
Provide trauma-informed, culturally responsive high-risk family nurse case management services.
Complete a comprehensive needs assessment and care plan, including the family's desired goals for health and wellness.
Utilize motivational interviewing style of communication to discuss diagnoses or risk specific education in alignment with family's desired goals.
Enhance the health and well-being of high-risk birthing families to reduce maternal and infant morbidity and mortality by the following methods :

Provide interventions to promote, destigmatize, and support identification and treatment of maternal mental health concerns.

Provide interventions to promote, destigmatize, and support identification and treatment of maternal substance use.

Provide interventions to reduce pregnancy and postpartum complications associated with pre-existing chronic medical conditions.

Provide interventions to reduce antepartum, intrapartum, and postpartum complications.

Provide interventions to promote a safe infant sleep environment.

Provide interventions to promote adequate maternal and infant nutrition.

Promote and support age-appropriate and diagnosis-appropriate growth and development.

Collaborate with family to identify and mitigate barriers to accessing desired supports and services.

Provide appropriate referrals to health-related and public assistance programs for active clients / families.

Refer clients / families who experience loss to professional bereavement services such as mental health therapy referral and / or perinatal bereavement support groups

Coordinate client / family care to other culturally responsive service providers in the community including primary care physicians and Medicaid managed care entities

Data Collection and Documentation

Maintain a tracking system for each family to ensure adequate coordination of care and timely (home / nurse) visit.

Document services provided timely on provided or approved data collection tool.

Ensure any data collection tool used is fully operational and maintained per state standards.

Ensure adequate level of security and privacy for confidentiality and safety of data using controls per state standards.

Provide and document appropriate referrals to health-related and public assistance programs for active clients / families.

Conduct the required contacts using the methods prescribed in the HRFCM Policy and Procedure Manual. Unsuccessful contact attempts should be documented.

Collect and retain data and records according to HRFCM Policy and Procedure Manual.

Ensure all clients / families are residents of Illinois at the time service is provided.

Outreach

Build and maintain strong relationships in the local community with medical providers, including but not limited to physicians, certified nurse midwives, nurse practitioners, physician assistants, mental health providers, and hospital labor and delivery and emergency room personnel.

Build and maintain strong relationships in the local community with social and human services providers, including but not limited to WIC, Early Childhood Home Visiting, Substance Use Prevention and Recovery, Housing Assistance, Welcoming Centers, and Community Based Organizations providing emergency items and supplies.

Establishment of a working relationship between the Local Agency and Medicaid Managed Care Organizations serving individuals within the Local Agency's service area, as directed by the Department of Human Services

Raising awareness to eligible populations on the benefit of the program and promote program enrollment to interested clients.

Evaluate outreach activities quarterly for effectiveness and keep an updated outreach plan.

Additional Duties and Responsibilities

Attend and participate in staff meetings, conferences, appropriate educational programs, trainings, and professional organizations to enhance professional development and promote best practices for culturally sensitive, clinically competent, and respectful services.

Demonstrate familiarity with policies, performance standards and the agency's Mission, Vision and Core Values.

Exhibit a positive attitude and maintain friendly and respectful relations with staff, children, and families.

Be a contributory team member in a positive / productive manner.

Maintain HIPAA and confidentiality policy.

QUALIFICATIONS

Registered Nurse is required.

Prior experience working with women, infants and children preferred.

Positive, empathic approach and ability to communicate effectively with families.

Possess excellent, highly developed listening skills and both written and oral communication skills.

Must be detail-oriented, able to think critically and efficiently organized with the ability to maintain detailed records.

Exhibits compassion, understanding and enjoys working with children and families.

Ability to work effectively in collaboration with diverse groups of people.

Passion, idealism, integrity, positive attitude, mission-driven, and self-directed.

CYHS CORE VALUES

Commitment - Meeting the needs of those we serve through professional services : Demonstrates a clear commitment to the agency's mission by exhibiting a shared concern for team members and clientele above personal interest. Has a healthy, manageable, and sustainable commitment to doing a job well and going above and beyond when it is truly required. Supports fundraising. Embraces new approaches and discovers ideas to create a better client experience. Establishes goals, clarifies tasks, plans work and actively participates in meetings. Pursues self-development that enhances job performance.

Compassion - Unconditional empathy for all.

Listens attentively to others and demonstrates an openness toward understanding concerns, feelings, and needs. Makes wise assessments and adjusts behavior and style to effectively address situation. Works effectively with people of different backgrounds, abilities, opinions, and perceptions.

Service - Community support through professionalism, accessibility, and advocacy.

Demonstrates a desire to serve others and fulfill community needs. Exhibits competence, good judgement, reliability, and polite behavior in order to meet the expectations of clients and the agency. Strives to provide service by means of advocacy.

Integrity - Upholding honesty, ethical principles, and moral values.

Takes responsibility for one's own actions. Acknowledges weaknesses and easily admits mistakes. Accurately assess personal feelings, strengths, and limitations and how they impact relationships. Makes sound judgements and transfers learning from one situation to another.

Teamwork - Collaboration among programs to reflect a diversity of ideas and service delivery.

Builds effective, supportive working relationships with team members. Reaches out to others in different programs for ideas, points out the contribution of others, shares credit, emphasizes team over self, and defines success collectively rather than individually. Seeks first to understand the other person's point of view and remains calm in challenging situations. Listens for understanding and meaning; speaks and writes effectively. Willing to assist other agency employees when they need help and willing to share ideas with others. Able to adjust behavior and style to adapt to needs of others on the team.

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RN CASE MANAGER - HOME VISITING (FULL-TIME)

What are the responsibilities and job description for the RN CASE MANAGER - HOME VISITING (FULL-TIME) position at Coordinated Youth and Human Services?

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