Care Manager (RN)

Molina Talent Acquisition; Detroit (MI); Presencial; USD 65.000 - 90.000; Jornada completa

Descripción de la vacante

Molina Healthcare, Inc. in Detroit, MI is seeking a Registered Nurse Care Manager to support care management activities and coordinate with a multidisciplinary team to deliver integrated member care across the continuum.

You will conduct comprehensive assessments, develop and monitor care plans, and travel locally as required (25-40%). The role promotes continuity of care with behavioral health, LTSS, and home/community resources, and requires an active RN license and 2+ years of healthcare

Formación

• RN with active state license and at least 2 years healthcare experience.
• Familiarity with EMR and HIPAA requirements.
• Strong communication, time management and ability to work independently.
• Valid driver's license with reliable transportation for travel.

Responsabilidades

• Completes comprehensive member assessments and determines care management eligibility.
• Develops and implements care coordination plans with member, caregiver, and professionals.
• Performs telephonic, in-person, or home visits as required.
• Monitors and documents care plan progress and updates interventions as needed.
• Maintains ongoing member caseload and conducts regular outreach.
• Promotes integration of services across behavioral health, LTSS, and home/community resources.
• Facilitates interdisciplinary care team meetings and collaboration.
• Uses motivational interviewing to educate and motivate change during contacts.
• Assesses barriers to care and provides coordination support.
• May consult peers and handle complex cases and medication reconciliation when needed.
• Travel 25-40% locally may be required.

Conocimientos

RN

Verbal communication

Written communication

Time management

Prioritization

Problem solving

Critical thinking

Independence

Multitasking

MS Office

Herramientas

Microsoft Office

Descripción del empleo

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.
• Assess 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).

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