Care Manager (Pediatrics) CALIFORNIA

Molina Healthcare; Long Beach (CA); Remote; USD 50,000 - 70,000; Full time

Job summary

Molina Healthcare is seeking a Case Manager to work remotely in San Diego, Riverside, or San Bernardino County. The role involves coordinating integrated care for members, performing clinical assessments, and developing care management plans. Candidates should have a background in healthcare, experience in case management, and relevant educational qualifications.

Qualifications

• Completion of an accredited LVN or LPN Program, or Bachelor's/Master's in social science.
• 1-3 years experience in case management or related fields.

Responsibilities

• Conduct clinical assessments and develop case management plans.
• Monitor care plans and collaborate with healthcare professionals.
• Promote integration of services for members.

Skills

Clinical Assessments

Care Coordination

Motivational Interviewing

Integrative Services

Education

Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program

Bachelor's or Master's Degree in Social Science

Job description

**California residency required. REMOTE in San Diego County/ Riverside county / San Bernardino County

JOB DESCRIPTION

Job Summary

Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

KNOWLEDGE/SKILLS/ABILITIES

• Completes clinical assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers from the assessment.
• Develops and implements 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.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member case load for regular outreach and management.
• Promotes integration of services for members including behavioral health care and long term services and supports to enhance the continuity of care for Molina members.
• May implement specific Molina wellness programs i.e. asthma and depression disease management.
• Facilitates interdisciplinary care team 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 RN case managers/supervisors as needed or required
• Case managers in Behavioral Health and Social Science fields may provide consultation, resources and recommendations to peers as needed
• Minimal travel may be required in the future. depending on the complexity level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina’s Central Programs unit.

JOB QUALIFICATIONS

REQUIRED EDUCATION:

Any of the following:

Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or Master's Degree (preferably in a social science, psychology, gerontology, public health or social work or related

REQUIRED EXPERIENCE:

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

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

If license required for the job, license must be active, unrestricted and in good standing.

Must have valid driver’s license with good driving record and be able to drive within applicable state or locality with reliable transportation.

PREFERRED EXPERIENCE:

3-5 years in case management, disease management, managed care or medical or behavioral health settings.

Prior working experience with Pediatric Case Management, any Regional Center (RC), CCS (California Children Services, ABA (applied behavior analysis), BHT (Behavioral Health Therapy, IHSS (In home support services), APS / CPS (adult/ child protective services), care plan development experience

Bilingual Spanish

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

Any of the following:

Licensed Clinical Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education and Promotion (CHEP), Licensed Professional Counselor (LPC/LPCC), Respiratory Therapist, or Licensed Marriage and Family Therapist (LMFT).

Masters Degree preferred.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

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