Care Manager

Molina Healthcare, Inc.; Deerfield Beach (FL); On-site; USD 33,000 - 64,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a care management specialist to support coordination across the continuum of member care. You will collaborate with a multidisciplinary team to ensure timely assessments, care plans, and progress toward desired outcomes.

The role includes home visits or telephonic interactions, ongoing monitoring, and facilitating ICT meetings. Local travel (25-40%) may be required depending on state contracts.

Qualifications

• At least 2 years experience in health care, preferably in care management.
• Clinical licensure and/or certification required only if state contract or regulation requires it.
• Valid driver's license, reliable transportation, and auto insurance for job travel.
• Demonstrated knowledge of community resources.
• Ability to work independently and with diverse populations.
• Proficiency in Microsoft Office Suite.

Responsibilities

• Support care management/care coordination activities with multidisciplinary team.
• Complete assessments and determine eligibility for care coordination.
• Develop and implement care plans with member, caregivers and providers.
• Conduct telephonic, in-person or home visits as required.
• Monitor care plans and adjust as needed to achieve goals.
• Maintain ongoing member caseload and outreach.
• Promote integration of behavioral health, LTSS, and community resources.
• Facilitate ICT meetings and collaboration.
• Provide education and motivation using motivational interviewing.
• Address barriers to care and assist members accordingly.
• Collaborate with licensed care managers as needed.
• Travel 25-40% may be required depending on state/contractual needs.

Skills

Care coordination

Communication skills

Time management

Problem-solving

Independence

Education

Bachelor's degree in healthcare or related field

Tools

MS Office

Job description

JOB DESCRIPTION Job Summary

Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

• Completes assessments of members per regulated timelines and determines who may qualify for care coordination/care management based on triggers identified in assessments.
• Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• Collaborates with licensed care managers/leadership as needed or required.
• 25- 40% estimated local travel may be required (based upon state/contractual requirements).

JOB DESCRIPTION Job Summary

Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• Completes assessments of members per regulated timelines and determines who may qualify for care coordination/care management based on triggers identified in assessments.
• Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• Collaborates with licensed care managers/leadership as needed or required.
• 25- 40% estimated local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
• Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Demonstrated knowledge of community resources.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations
• Ability to work independently, with minimal supervision and self-motivation.
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $24 - $46.81 / HOURLY

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