TrueCare is a Mississippi non-profit, provider-sponsored health plan formed by a coalition of Mississippi hospitals and health systems throughout the state and supported by CareSource’s national leadership in quality and operational excellence. TrueCare offers locally based provider services through provider engagement representatives and customer care. Our sole mission is to improve the health of Mississippians by leveraging local physician experience to inform decision-making, aligning incentives, using data more effectively, and reducing friction between the delivery and financing of health care. By doing so, TrueCare will change the way health care is delivered in Mississippi.
Job Summary:The Lactation Consultant, RN works collaboratively with a multidisciplinary specialized maternity team, including obstetricians, pediatricians, nurses, behavioral specialists and social workers, to ensure a comprehensive approach to maternal and infant care.
Essential Functions:- Conduct assessments to identify the unique needs of breastfeeding mothers engaged in the Mom and Baby Beginnings or NICU CM programs.
- Provide individualized education and support and develop tailored care plans to address challenges related to breastfeeding using evidenced-based information on breastfeeding techniques, milk-production, nutrition, maternal and infant wellbeing.
- Engage members and their support systems using strength-based assessments and a trauma-informed care approach.
- Utilize motivational interviewing techniques to conduct health and psychosocial assessments through a health equity lens, addressing cultural, linguistic, social, and environmental factors that impact health and access.
- Facilitate regular interdisciplinary care team (ICT) meetings to address member needs.
- Establish effective, professional relationships with members through phone or electronic communication.
- Develop and regularly update a person-centered individualized care plan (ICP) in collaboration with the ICT, reflecting the member’s desires and preferences.
- Identify and manage barriers to achieving care plan goals and implement effective interventions based on clinical standards and best practices.
- Educate members and their support systems about treatment options, community resources, and insurance benefits to enable informed decision-making.
- Conduct ongoing assessments and documentation to evaluate member progress on the ICP and ensure satisfaction through open communication.
- Monitor and promote effective use of healthcare resources, ensuring compliance with clinical variance and benefits management.
- Verify member eligibility, enrollment history, demographics, and health status.
- Collaborate to ensure timely psychosocial and behavioral assessments, gathering information from members, families, providers, and stakeholders.
- Coordinate with community organizations and state agencies to ensure service coordination and avoid duplication.
- Adjust program interventions based on guidelines and member preferences, as well as changes in healthcare needs
- Conclude care coordination services according to established guidelines for members not enrolled in ongoing care.
- Provide clinical oversight to unlicensed team members as appropriate
- Document care coordination activities and member responses promptly, adhering to CareSource policies.
- Continuously assess and improve processes to enhance the member experience and share insights with leadership.
- Ensure adherence to NCQA and CMSA standards
- Perform any other job related duties as requested.
Education and Experience:- Associates degree required
- Bachelor's degree in nursing or related field preferred
- Equivalent years of relevant work experience may be accepted in lieu of required education
- Three (3) years of clinical experience in maternal/child nursing required
- Affiliation with professional nursing and lactation organizations highly desirable required
Competencies, Knowledge and Skills:- Strong understanding of Quality, HEDIS, disease management, supportive medication reconciliation and adherence
- Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel
- Ability to communicate effectively with a diverse group of individuals
- Ability to multi-task and work independently within a team environment
- Knowledge of local, state & federal healthcare laws and regulations & all company policies regarding case management practices
- Adhere to code of ethics that aligns with professional practice
- Knowledge of and adherence to Case Management Society of America (CMSA) standards for case management practice
- Strong advocate for members at all levels of care
- Strong understanding and sensitivity of all cultures and demographic diversity
- Ability to interpret and implement current research findings
- Awareness of community & state support resources
- Critical listening and thinking skills
- Decision making and problem-solving skills
- Strong organizational and time management skills
Licensure and Certification:- Current, unrestricted RN licensure in state of practice required
- Certification with the International Board of Lactation Consultant Examiners or Certified Lactation Counselor required
Working Conditions:- General office environment; may be required to sit or stand for extended periods of time
- Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members.
- Travel is not typically required
Compensation Range:
$62,700.00 - $100,400.00
CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
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