Maternal & Child/EPSDT Coordinator (RN) - Remote in NE

Job Description

Job Summary

The MCH/EPSDT Coordinator is responsible for facilitating, implementing and coordinating all EPSDT activities for member children as well as identifying, engaging and tracking pregnant members and their postpartum care. Facilitates and coordinates member access to periodic preventative healthcare services for all eligible populations and is responsible for identifying gaps in or barriers to care. Reviews EPSDT and HEDIS data to inform targeted interventions to increase utilization of well-child visits, screenings, exams, and associated services; and improving communication and collaboration among Members, Providers, school health services, CBOs, and other program stakeholders.

Job Duties

• Designs programs to ensure that all member children receive necessary EPSDT services.
• Designs programs to ensure that all pregnant members receive maternal and postpartum care
• Identifies and coordinates assistance for identified member needs, specific to maternal/child health and EPSDT.
• Provide education and outreach initiatives to include:
  • Various one-on-one supports such as EPSDT education services, HNAS, and appointment and transportation assistance.
  • Member incentives and community events such as back-to-school fairs and community baby showers, using them as opportunities to educate communities about the importance of preventive healthcare and how to access EPSDT services.
  • May use MyHealth Mobile stationed near homeless shelters, food banks, community centers, and public social service offices to improve access to preventive services in diverse communities that struggle with disparities in health outcomes.
  • Participate in Molina Days. Promote a healthy lifestyle at events at Provider offices and FQHCs for Members to receive well-child/well-baby exams, vaccinations, and other EPSDT services. Educate Members on the importance of healthy eating, physical activity, and preventive care.
  • Provides members, providers and community-based organizations information on a variety of options for accessing preventive services and outreach initiatives
• Determine EPSDT program effectiveness by monitoring service utilization through the review of member records, conduct random audits of provider records, and track compliance with the American Academy of Pediatrics’ periodicity schedule and applicable HEDIS and Molina Compass metrics.
• The EPSDT Coordinator identifies Members who are out of compliance with the Bright Futures periodicity schedule.
• Maintains dashboards of EPSDT measures, including trends and gaps in services. Oversees design and implementation of campaigns and programs to address gaps at Member, Provider, and system levels related to the EPSDT program, supports provider education and engagement, and provides information about members’ SDOH needs, race, ethnicity, and language preferences.
• Track Member Screenings, Diagnosis, and Treatment Within Established Time Frame via appointment records, track required/recommended screenings data from claims submissions, immunization registries, and encounter data shared by health plans already operating in the State.

Job Qualifications

REQUIRED EDUCATION:

Associate’s or Bachelor’s Degree

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

3-5 years in case management, disease management, managed care or medical or home health.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

• Must be a current, licensed RN.
• License must be active unrestricted and in good standing.
• Must have valid driver’s license with good driving record and be able to drive within applicable state or locality with reliable transportation.

PREFERRED EXPERIENCE:

Prior experience with EPDST and HEDIS

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.