Registered Nurse Case Coordinator

2 weeks ago

Riverside, California, United States Molina Healthcare Full time

POSITION: REGISTERED NURSE CASE MANAGER for Molina Healthcare. Candidates must reside in California, specifically in Sacramento County, LA County, San Diego County, San Bernardino, or Riverside County. Bilingual Spanish is preferred.

We are seeking an RN with a minimum of 1 year of relevant experience in Case Management. Experience in Ambulatory Case Management, OB GYN Case Management, or Disease Management is preferred.

The Case Manager RN will operate in both remote and field environments, focusing on our Medicaid Population and facilitating transitions from inpatient care to subsequent steps. This role is crucial in ensuring that our members experience a successful discharge from the hospital to their homes. Strong computer skills and meticulous attention to detail are essential for managing multiple systems, communicating with members via phone, and accurately documenting contact notes. This position is fast-paced, and productivity is a key focus. Proficiency in EMRs and Microsoft Office is required.

Future travel may be necessary for member visits within a 1-2 hour radius of the candidate's residence. A clean driving record, proof of auto insurance, and reliable transportation are mandatory. Candidates should consider this requirement before applying. Mileage reimbursement is provided.

Home office setup with high-speed internet is required. Candidates must furnish their own home office equipment, including a desk and chair.

WORK SCHEDULE: Monday to Friday, 8:30 AM to 5:30 PM Pacific Time.

JOB SUMMARY

Molina Healthcare Services (HCS) collaborates with members, providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate an integrated care delivery system across the continuum, which includes behavioral health and long-term care for members with significant needs. HCS staff are dedicated to ensuring that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the service location.

KNOWLEDGE/SKILLS/ABILITIES

  • Conduct comprehensive assessments of members within regulated timelines to determine eligibility for case management based on clinical judgment, health changes, or psychosocial factors.
  • Develop and implement a case management strategy in collaboration with the member, caregiver, physician, and other healthcare professionals to meet the member's needs and objectives.
  • Perform face-to-face or home visits as necessary.
  • Monitor the care plan continuously to assess effectiveness, document interventions, and recommend adjustments as needed.
  • Maintain an ongoing member caseload 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% may be required.
  • RNs will offer consultation, recommendations, and education to non-RN case managers as appropriate.
  • RNs will manage cases involving members with complex medical conditions and medication regimens.
  • Conduct medication reconciliation when necessary.

JOB QUALIFICATIONS

Required Education: Graduate from an Accredited School of Nursing. A Bachelor's Degree in Nursing is preferred.

Required Experience: 1-3 years in case management, disease management, managed care, or medical/behavioral health settings.

Required License, Certification, Association: Active, unrestricted State Registered Nursing (RN) license in good standing.

Must possess a valid driver's license with a good driving record and be able to drive within the applicable state or locality with reliable transportation.

Preferred Education: Bachelor's Degree in Nursing.

Preferred Experience: 3-5 years in case management, disease management, managed care, or medical/behavioral health settings.

Preferred License, Certification, Association: Active, unrestricted Certified Case Manager (CCM).

Molina Healthcare is a nationwide Fortune 500 organization committed to providing quality healthcare to individuals receiving government assistance. We offer a competitive benefits and compensation package and are an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time

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