Care Manager (Rn)

Molina Healthcare; Berlin (OH); On-site; USD 36,000 - 71,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a Registered Nurse (RN) Care Manager to support care management and coordination across care settings. You will work with a multidisciplinary team to improve outcomes and deliver cost-effective care for members.

You will perform comprehensive assessments, develop and monitor care plans, and conduct home visits as needed. Travel up to 40% may be required, and strong communication and independent work are essential.

Qualifications

• At least 2 years of health care experience, preferably in care management.
• RN license active and unrestricted in state of practice.
• Valid driver’s license with reliable transportation.
• Understanding of EMR systems and HIPAA.
• Knowledge of community resources and services.
• Ability to work independently with minimal supervision.
• Strong communication and time-management skills.
• Proficient with Microsoft Office and online portals.

Responsibilities

• Complete comprehensive assessments within regulated timelines and determine eligibility for care management.
• Develop and implement care coordination plans with member, caregivers, physicians, and providers.
• Conduct telephonic, face-to-face, or home visits as required.
• Monitor care plans and document interventions and outcomes.
• Maintain ongoing member caseload with regular outreach.
• Promote integration of behavioral health, LTSS, and community resources.
• Facilitate interdisciplinary care team (ICT) meetings and collaboration.
• Use motivational interviewing to educate and motivate change.
• Assess barriers to care and provide coordination to address concerns.
• Provide consultation and recommendations to peers as needed.
• Handle complex cases and medication reconciliation as assigned.
• Travel 25-40% locally as required by state/contractual needs.

Skills

Communication skills

Time management

Attention to detail

Interpersonal skills

Critical thinking

Independent work

Education

Registered Nurse (RN) license

Tools

EMR

Microsoft Office

Online portals

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.

Essential Job Duties

• Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments.
• Develops and implements care coordination 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.
• May provide consultation, resources and recommendations to peers as needed.
• Care manager RNs may be assigned complex member cases and medication regimens.
• Care manager RNs may conduct medication reconciliation as needed.
• 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.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA).
• 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.
• Responsiveness in all forms of communication, and ability to 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 proficiency, and ability to navigate online portals and databases.

Preferred Qualifications

• Certified Case Manager (CCM).

Pay Range: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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