Case Manager

3 weeks ago

Madison, United States Molina Healthcare Full time
Job Description

JOB DESCRIPTION

Job Summary

Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

 

KNOWLEDGE/SKILLS/ABILITIES

  • Completes face-to-face comprehensive assessments of members per regulated timelines.
  • Facilitates comprehensive waiver enrollment and disenrollment processes.
  • Develops and implements a case management plan, including a waiver service plan, in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.
  • Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
  • Promotes integration of services for members including behavioral health care and long term services and supports, home and community to enhance the continuity of care for Molina members.
  • Assesses for medical necessity and authorize all appropriate waiver services.
  • Evaluates covered benefits and advise appropriately regarding funding source.
  • Conducts face-to-face or home visits as required.
  • Facilitates interdisciplinary care team meetings for approval or denial of services and informal ICT collaboration.
  • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
  • Assesses for barriers to care, provides care coordination and assistance to member to address psycho/social, financial, and medical obstacles concerns.
  • Identifies critical incidents and develops prevention plans to assure member's health and welfare.
  • Provides consultation, recommendations and education as appropriate to non-RN case managers
  • Works cases with members who have complex medical conditions and medication regimens
  • Conducts medication reconciliation when needed.
  • 50-75% travel required.

 

JOB QUALIFICATIONS

Required Education

Graduate from an Accredited School of Nursing

Required Experience

  • At least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports.
  • 1-3 years in case management, disease management, managed care or medical or behavioral health settings.
  • Required License, Certification, Association
  • Active, unrestricted State Registered Nursing license (RN) in good standing
  • If field work is required, Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

State Specific Requirements

Virginia: Must have at least one year of experience working directly with individuals with Substance Use Disorders

Preferred Education

Bachelor's Degree in Nursing

Preferred Experience

  • 3-5 years in case management, disease management, managed care or medical or behavioral health settings.
  • 1 year experience working with population who receive waiver services.

Preferred License, Certification, Association

Active and unrestricted Certified Case Manager (CCM)

 

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.

#PJHS

Pay Range: $23.76 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

  • Case Manager

    5 days ago

    Madison, United States Soar Case Management Services Inc. Full time

    **Case Manager** **SOAR Case Management Services Inc. (SOAR)**, is seeking an experienced, responsive, trauma informed full-time **Case Manager** to join our team. We offer a casual, collaborative, dog friendly work environment in Madison, WI. This is an in-person position at our Madison office with working hours of 8:00 am to 5:00 pm, Monday thru Friday...

  • Housing Case Manager

    1 month ago

    Madison, United States The Salvation Army Full time

    **The Salvation Army Mission**: The Salvation Army, an international movement, is an evangelical part of the universal Christian church. Its message is based on the Bible. Its ministry is motivated by the love of God. Its mission is to preach the gospel of Jesus Christ and to meet human needs in His name without discrimination. **Job Objective**: Assesses...

  • Case Manager-Addictions

    24 hours ago

    Madison, United States Rogers Behavioral Health Full time

    This is a full-time role, working M-F day shift clinic hours within our Addictions program here at Rogers in Madison.The Case Manager is responsible for supporting patient care by coordinating and arranging continuing care and basic needs resources per patient, communicating with collateral partners and treatment team any barriers to care, and supporting...

  • Case Manager-Addictions

    5 days ago

    Madison, United States Rogers Behavioral Health Full time

    This is a full-time role, working M-F day shift clinic hours within our Addictions program here at Rogers in Madison.The Case Manager is responsible for supporting patient care by coordinating and arranging continuing care and basic needs resources per patient, communicating with collateral partners and treatment team any barriers to care, and supporting...

  • Case Manager-Addictions

    2 weeks ago

    Madison, United States Rogers Behavioral Health Full time

    This is a full-time role, working M-F day shift clinic hours within our Addictions program here at Rogers in Madison.The Case Manager is responsible for supporting patient care by coordinating and arranging continuing care and basic needs resources per patient, communicating with collateral partners and treatment team any barriers to care, and supporting...

  • Rapid Rehousing

    3 days ago

    Madison, United States YWCA of Madison Full time

    **Rapid Rehousing (RRH) Case Manager** This is a full-time (36 hours per week), salaried position. We offer an excellent benefits package and starting salary of $50,000/year. AA/EOE

  • Home Health RN Case Manager

    3 days ago

    Madison, United States Oakwood Village Univ Woods Homes, Inc. Full time

    Job DescriptionJob DescriptionTo assess, provide, coordinate and direct the Home Health patient’s care based on the individual needs of the Home Health client. The RN Case Manager is responsible for the independent management of the Home Health population using the nursing process in the residential environment. The RN Case Manager is responsible for OASIS...

  • Case Manager PRN 90 day opportunity

    1 week ago

    Madison, United States Nitelines USA, Inc Full time

    Nite Lines USA is looking for a Case Manager to join the team! The Case Manager would be conducting visits in Madison/ Greene counties. Must have very strong Foster Care experience and skills and be able to hit the ground running. Salary-$33.50/hr. 1099 contractor mileage available but you must complete a weekly form with the case info, mileage, and...

  • Veterans Transitional Housing Program

    6 days ago

    Madison, United States Porchlight, Inc. Full time

    Job DescriptionJob DescriptionSUMMARY OF PRIMARY FUNCTIONThe Veterans Transitional Housing Program (VTHP) Case Manager provides participants with supportive services designed to overcome financial, personal, health, employment, and other functional barriers. Additionally, the Case Manager creates an individualized service plan with each Veteran that promotes...

  • Veterans Transitional Housing Program

    3 days ago

    Madison, United States Porchlight, Inc. Full time

    Job DescriptionJob DescriptionSUMMARY OF PRIMARY FUNCTIONThe Veterans Transitional Housing Program (VTHP) Case Manager provides participants with supportive services designed to overcome financial, personal, health, employment, and other functional barriers. Additionally, the Case Manager creates an individualized service plan with each Veteran that promotes...

  • Case Manager-Addictions

    2 weeks ago

    Madison Clinic, Madison, WI, United States Rogers Behavioral Health Full time

    This is a full-time role, working M-F day shift clinic hours within our Addictions program here at Rogers in Madison.The Case Manager is responsible for supporting patient care by coordinating and arranging continuing care and basic needs resources per patient, communicating with collateral partners and treatment team any barriers to care, and supporting...

  • RN- Transitional Care Case Manager Per Diem Option 2

    1 week ago

    Madison, United States UW Health Full time

    Per Diem Registered Nurses must commit to work a minimum of seventy-two (72) hours per six (6) week scheduling period as follows: The Per Diem may be required to work evening and/or night shifts, weekend hours, and holiday hours. This position is anticipated to work a 40% FTE. You will be working at University Hospital and East Madison Hospital in Madison,...

  • RN- Transitional Care Case Manager Per Diem Option 2

    1 week ago

    Madison, United States UW Health Full time

    Per Diem Registered Nurses must commit to work a minimum of seventy-two (72) hours per six (6) week scheduling period as follows: The Per Diem may be required to work evening and/or night shifts, weekend hours, and holiday hours. This position is anticipated to work a 40% FTE. You will be working at University Hospital and East Madison Hospital in Madison,...

  • RN- Transitional Care Case Manager Per Diem Option 2

    2 weeks ago

    Madison, United States UW Health Full time

    Per Diem Registered Nurses must commit to work a minimum of seventy-two (72) hours per six (6) week scheduling period as follows: The Per Diem may be required to work evening and/or night shifts, weekend hours, and holiday hours. This position is anticipated to work a 40% FTE. You will be working at University Hospital and East Madison Hospital in Madison,...

  • RN- Transitional Care Case Manager Per Diem Option 2

    2 weeks ago

    Madison, United States UW Health Full time

    Job Description Per Diem Registered Nurses must commit to work a minimum of seventy-two (72) hours per six (6) week scheduling period as follows: The Per Diem may be required to work evening and/or night shifts, weekend hours, and holiday hours. This position is anticipated to work a 40% FTE. You will be working at University Hospital and East Madison...

  • Home Health RN Case Manager

    24 hours ago

    Madison, WI, United States Oakwood Village West Full time

    To assess, provide, coordinate and direct the Home Health patient's care based on the individual needs of the Home Health client. The RN Case Manager is responsible for the independent management of the Home Health population using the nursing process in the residential environment. The RN Case Manager is responsible for OASIS documentation, data collection,...

  • Project Manager

    1 month ago

    Madison, United States Match Inc Full time

    **Job Title : Project Manager** **Location : Madison ,WI** **Duration : 12 months** **Job Description**: Under general supervision, this position provides advanced project leadership for complex projects which have a significant departmental impact, that cross organization and/or agency lines, and involve from various DOT business areas and involve a...

  • RN- Transitional Care Case Manager Per Diem Option 2

    1 week ago

    Madison, WI, United States UW Health Full time

    Per Diem Registered Nurses must commit to work a minimum of seventy-two (72) hours per six (6) week scheduling period as follows: The Per Diem may be required to work evening and/or night shifts, weekend hours, and holiday hours. This position is anticipated to work a 40% FTE. You will be working at University Hospital and East Madison Hospital in Madison,...

  • RN- Transitional Care Case Manager Per Diem Option 2

    1 week ago

    Madison, WI, United States UW Health Full time

    Per Diem Registered Nurses must commit to work a minimum of seventy-two (72) hours per six (6) week scheduling period as follows: The Per Diem may be required to work evening and/or night shifts, weekend hours, and holiday hours. This position is anticipated to work a 40% FTE. You will be working at University Hospital and East Madison Hospital in Madison,...

  • Case Manager in Dane County

    3 weeks ago

    Madison, United States Community Action Coalition For South Central WI, Inc. Full time

    Job DescriptionJob DescriptionCommunity Action Coalition for South Central Wisconsin works to develop the economic and social capacities of individuals, families and communities in Dane, Jefferson, and Waukesha Counties. The Caseworker is responsible for developing relationships with participants to assess their needs and connect them to wraparound services....