Care Manager - Behavioral Health

Molina Healthcare; Marion (SC); Remote; USD 60,000 - 80,000; Full time

Job summary

Molina Healthcare is seeking a Case Manager to support the Medicaid SMI population in South Carolina. This role involves telephonic and face-to-face communication, developing care plans, and ensuring quality care. Candidates must have an RN license and experience in case management. The position requires local travel and offers a competitive salary based on qualifications and experience.

Benefits

Competitive benefits

Qualifications

• Active, unrestricted State RN license in good standing.
• 1-3 years in case management or healthcare settings.
• Valid driver’s license with a good driving record.

Responsibilities

• Conduct comprehensive assessments and determine eligibility for case management.
• Develop and implement case management plans collaboratively.
• Monitor care plans and document interventions.

Skills

Attention to detail

Communication

Multitasking

Education

Bachelor's Degree in Nursing

Graduate from an accredited School of Nursing

Job description

JOB DESCRIPTION

The Case Manager will work remotely and in the field supporting our Medicaid SMI (Severe Mental Illness) Population in South Carolina. The role requires telephonic communication and face-to-face meetings, participation in interdisciplinary care team meetings, and ensuring members have appropriate care plans based on their needs. Excellent computer skills and attention to detail are essential for multitasking across systems, communicating with members, and documenting contacts accurately. This is a fast-paced position where productivity is key.

TRAVEL (up to 60%) in the field for member visits in surrounding areas is required. Candidates should reside in East to North East South Carolina.

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

Schedule: Monday to Friday, 8:00 AM to 5:00 PM EST. No weekends or holidays.

Job Summary

Molina Healthcare Services (HCS) collaborates with members, providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate integrated care across behavioral health and long-term services, focusing on members with high-need potential. The goal is to ensure progress toward desired outcomes with quality, medically appropriate, and cost-effective care based on illness severity and service site.

KNOWLEDGE/SKILLS/ABILITIES

• Complete comprehensive assessments of members within regulated timelines and determine eligibility for case management based on clinical judgment, health or psychosocial changes, and assessment triggers.
• Develop and implement case management plans collaboratively with members, caregivers, physicians, and other healthcare professionals to address needs and goals.
• Conduct face-to-face or home visits as required.
• Monitor care plans regularly to evaluate effectiveness, document interventions, and adjust goals as needed.
• Maintain an ongoing member caseload for outreach and management.
• Promote service integration, including behavioral health and long-term services/supports, to enhance continuity of care.
• Facilitate interdisciplinary care team meetings and collaborate informally with ICT.
• Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate members.
• Identify barriers to care and assist members in overcoming them.
• Travel requirements: 25-40% local travel.
• RNs provide consultation, recommendations, and education to non-RN case managers.
• RNs handle cases with complex medical conditions and medication regimens and conduct medication reconciliation when needed.

JOB QUALIFICATIONS

Required Education

Graduate from an accredited School of Nursing; Bachelor's Degree in Nursing 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 RN license in good standing; valid driver’s license with a good driving record and reliable transportation.

Preferred Education

Bachelor’s Degree in Nursing.

Preferred Experience

3-5 years in relevant healthcare management settings.

Preferred License, Certification, Association

Active, unrestricted CCM certification.

Interested Molina employees should apply through the intranet.

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

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Pay Range: $25.08 - $51.49/hour. Actual compensation varies based on location, experience, education, and skills.