RN Case Manager for Medicaid Population

7 days ago

Scranton, South Carolina, United States Molina Healthcare Full time

Company Overview

Molina Healthcare is a healthcare company dedicated to improving the health and well-being of its members.

Job Summary

We are seeking a highly skilled RN Case Manager to join our team. This individual will work in remote and field settings, supporting our Medicaid SMI population in South Carolina.

About the Role

The RN Case Manager will be responsible for communicating telephonically and completing Face-to-Face meetings with members. They will participate in interdisciplinary care team meetings, ensuring that members have care plans based on their concerns and health needs. Excellent computer skills and attention to detail are essential for multitasking between systems, speaking with members on the phone, and entering accurate contact notes.

Responsibilities

  • Conduct comprehensive assessments of members per regulated timelines and determine who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified in the assessment.
  • Develop and implement a case management 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.
  • Perform ongoing monitoring of the care plan to evaluate effectiveness, document interventions, and goal achievement, and suggest changes accordingly.
  • Maintain ongoing member case load for regular outreach and management.
  • Promote 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.
  • Facilitate interdisciplinary care team meetings and informal ICT collaboration.
  • Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate change during member contacts.
  • Assess for barriers to care, provide care coordination, and assistance to member to address concerns.

Requirements

  • Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.
  • 1-3 years in case management, disease management, managed care or medical or behavioral health settings.
  • Active, unrestricted State Registered Nursing (RN) license in good standing.

What We Offer

  • A competitive salary range of $25.08 - $51.49 per hour, depending on experience.
  • A benefits package that includes health insurance, retirement savings, and paid time off.
  • The opportunity to work with a dynamic team of healthcare professionals dedicated to improving the health and well-being of our members.

Contact Information

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