Registered Nurse Case Manager

2 weeks ago


Reno, Nevada, United States Molina Healthcare Full time
Job Overview

Molina Healthcare is looking for a dedicated RN (Registered Nurse) Case Manager. The ideal candidate should possess strong computer skills and a keen attention to detail, enabling them to efficiently navigate various systems, communicate with members via phone, and accurately document interactions.

This role is primarily remote, allowing you to work from home; however, field visits to meet with members will be necessary. Travel expenses will be reimbursed.

Work Schedule: Monday to Friday, 8:00 AM to 5:00 PM, with a one-hour lunch break.

Further information will be provided during the interview process.

Position Summary

Molina Healthcare Services (HCS) collaborates with members, healthcare providers, and multidisciplinary teams to evaluate, facilitate, plan, and coordinate comprehensive care delivery across various settings, 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.
  • Collaborate with members, caregivers, physicians, and other healthcare professionals to develop and implement tailored case management plans that address individual needs and goals.
  • Perform in-person visits as required to ensure effective care coordination.
  • Monitor the effectiveness of care plans, documenting interventions and outcomes, and making necessary adjustments.
  • Maintain an ongoing caseload for regular outreach and management of member needs.
  • Encourage the integration of services, including behavioral health and long-term support, to enhance continuity of care.
  • Facilitate interdisciplinary team meetings and foster collaboration among team members.
  • Utilize motivational interviewing techniques to educate and support members in achieving health-related changes.
  • Identify barriers to care and provide necessary coordination and assistance to address these challenges.
  • Local travel of 25-40% is required.
  • Provide guidance and education to non-RN case managers as needed.
  • Manage cases involving members with complex medical conditions and medication regimens.
  • Conduct medication reconciliation when necessary.

Qualifications

Education: Graduate from an accredited nursing program; a Bachelor's Degree in Nursing is preferred.

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

Licensure: Must hold an 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:

Education: Bachelor's Degree in Nursing.

Experience: 3-5 years in relevant case management or healthcare settings.

Licensure: Active, unrestricted Certified Case Manager (CCM) certification.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare 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.



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