Care Manager (Rn)

Jobtome; Issaquah (WA); Presencial; USD 36.000 - 82.000; Jornada completa

Descripción de la vacante

Molina Healthcare in the United States is seeking a Registered Nurse Care Manager to provide care management and coordination across the continuum, collaborating with a multidisciplinary team to improve member outcomes and manage costs.

The role includes performing comprehensive assessments, developing care plans, conducting visits, monitoring progress, and promoting integration of services including behavioral health and LTSS. Travel 25-40% may be required.

Formación

• At least 2 years of experience in health care, preferably in care management or equivalent.
• RN license active and unrestricted in state of practice.
• Valid driver's license and reliable transportation for travel requirements.
• Understanding of EMR and HIPAA regulations.
• Demonstrated knowledge of community resources.
• Ability to operate proactively with attention to detail.
• Ability to work in diverse settings and with varied populations.
• Strong verbal and written communication skills.
• Proficient with Microsoft Office and navigating online portals/databases.
• Excellent problem-solving and critical-thinking abilities.

Responsabilidades

• Completes comprehensive assessments within regulated timelines and determines eligibility for care management.
• Develops and implements care coordination plan with member, caregiver, physician and care team.
• Conducts telephonic, face-to-face or home visits as required.
• Monitors care plan effectiveness, documents interventions and suggests changes.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services including behavioral health, LTSS, and community resources.
• Facilitates interdisciplinary care team meetings and collaboration.
• Uses motivational interviewing to educate and motivate change.
• Assesses barriers to care and provides coordination assistance to member.
• May provide consultation and resources to peers.
• Care manager RNs may handle complex cases and medication reconciliation.
• Travel 25-40% may be required.

Conocimientos

Communication skills

Time management

Organizational skills

Microsoft Office

Independence

Educación

Registered Nurse (RN) license

Certified Case Manager (CCM)

Herramientas

EMR systems

Online portals/databases

Descripción del empleo

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.


• 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).


• Experience working with Behavioral Health conditions, including serious mental illness, anxiety, depression, substance use disorders and/or co-occurring medical and behavioral health needs is preferred.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $26.41 - $59.21 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.