Registered Nurse Case Coordinator

2 weeks ago

Portsmouth, Virginia, United States Molina Healthcare Full time

POSITION SUMMARY


We are currently seeking a dedicated Registered Nurse (RN) to join our team as a Case Coordinator. This role is essential for supporting our Medicaid population and requires candidates to be licensed in the state of Virginia.

The Case Coordinator will operate in both remote and field environments, engaging with members directly through home visits to conduct face-to-face assessments.

As part of an interdisciplinary care team, you will play a crucial role in developing and implementing care plans tailored to the individual health needs and concerns of our members.

Regular assessments are mandated every six months, with additional evaluations required following hospitalizations.

Strong computer proficiency and meticulous attention to detail are vital for managing multiple systems, communicating effectively with members, and documenting accurate contact notes.

This role demands a fast-paced approach with a focus on productivity.


TRAVEL (up to 10%) may be necessary for member visits in surrounding areas, with mileage reimbursement provided.

We are looking for candidates from various regions within Virginia.

A home office with high-speed internet connectivity is required.

WORK SCHEDULE:
Monday to Friday, 8:00 AM to 5:00 PM. - No weekends or holidays.

JOB OVERVIEW


Molina Healthcare Services (HCS) collaborates with members, healthcare providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate comprehensive care delivery across various settings, including behavioral health and long-term care for members with significant needs.

Our staff is committed to ensuring that patients achieve their desired health outcomes through quality care that is both medically appropriate and cost-effective, considering the severity of illness and the service location.

KNOWLEDGE/SKILLS/ABILITIES


Follow members throughout a 30-day program that begins at hospital admission and continues through transitions to other care settings, including nursing facilities and private homes, aiming to reduce readmissions.


Ensure safe and appropriate transitions by collaborating with hospital discharge planners, hospitalists, outpatient providers, facility staff, and family/support networks as needed.


Facilitate member transitions to environments with adequate caregiving and functional support, alongside necessary medical and medication oversight.


Work with ancillary providers, public agencies, and other service providers to ensure that essential services and equipment are available for safe transitions.

Conduct face-to-face visits with all members during hospital stays and home visits for high-risk members post-discharge.

Coordinate care and reassess member needs using the Coleman Care Transitions Model recommended post-discharge timeline.


Educate and support members focusing on seven primary areas (ToC Pillars): medication management, personal health record usage, follow-up care, signs and symptoms of worsening conditions, nutrition, functional needs, and advance directives.

Utilize motivational interviewing techniques and Molina clinical guideposts to educate, support, and inspire change during member interactions.

Identify barriers to care, provide coordination, and assist members in addressing their concerns.

Facilitate interdisciplinary care team meetings and informal collaborations.

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 as necessary.

40-50% local travel may be required.

QUALIFICATIONS
Required Education

Graduate from an accredited nursing program. A Bachelor's Degree in Nursing is preferred.

Required Experience

1-3 years of experience in hospital discharge planning or home health.

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 of experience in hospital discharge planning or home health.

Preferred License, Certification, Association

Active, unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager (CCM)

COMPANY OVERVIEW
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 / HOURLY

*Actual compensation may vary based on geographic location, work experience, education, and/or skill level.

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