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Registered Nurse Case Manager
2 months ago
Molina Healthcare is looking for a dedicated RN (Registered Nurse) Case Manager. The ideal candidate will possess strong computer skills and meticulous attention to detail, essential for managing multiple systems, engaging with members via phone, and accurately documenting interactions.
This position is remote, allowing you to work from home, but will require travel within the area for member visits. Mileage expenses will be reimbursed.
Work Schedule: Monday to Friday, 8:00 AM to 5:00 PM, with a 1-hour lunch break.
Further details will be provided during the interview process.
Position Summary
Molina Healthcare Services (HCS) collaborates with members, healthcare providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate comprehensive care across various services, including behavioral health and long-term care for members with significant needs. HCS staff strive to ensure that patients achieve desired health outcomes through quality care that is both medically appropriate and cost-effective.
Key Responsibilities
- Conduct thorough assessments of members within regulated timelines to determine eligibility for case management based on clinical judgment and changes in health or psychosocial status.
- Develop and execute a tailored case management plan in partnership with the member, caregivers, physicians, and other relevant healthcare professionals to meet the member's needs and objectives.
- Perform in-person or home visits as necessary.
- Continuously monitor the care plan's effectiveness, document interventions, track goal achievement, and recommend adjustments as needed.
- Maintain an ongoing case load for regular outreach and management.
- Encourage service integration for members, including behavioral health and long-term services, to enhance continuity of care.
- Facilitate interdisciplinary care team meetings and informal collaborations.
- Utilize motivational interviewing techniques and Molina clinical guidelines to educate and support members during interactions.
- Identify barriers to care and provide coordination and assistance to address member concerns.
- Local travel of 25-40% is required.
- Provide consultation and education to non-RN case managers as appropriate.
- Manage cases involving members with complex medical conditions and medication regimens.
- Conduct medication reconciliation when necessary.
Qualifications
Education: Graduate from an Accredited School of Nursing; Bachelor's Degree in Nursing is preferred.
Experience: 1-3 years in case management, disease management, managed care, or medical/behavioral health settings.
Licensure: Active, unrestricted State Registered Nursing (RN) license in good standing. A valid driver's license with a clean driving record is also required.
Preferred Qualifications:
Bachelor's Degree in Nursing and 3-5 years of experience in relevant settings. Active, unrestricted Certified Case Manager (CCM) certification is also preferred.
Molina Healthcare offers a competitive benefits and compensation package and is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $51.49 per hour. Actual compensation may vary based on geographic location, work experience, education, and skill level.
