Care Manager (RN)

Molina Healthcare; United States; On-site; USD 33,000 - 71,000; Full time

Benefits offered by this job

Competitive benefits

Equal Opportunity Employer

Job summary

Molina Healthcare is seeking a Registered Nurse to join its care management team in the United States. The role involves coordinating member care, completing assessments, developing care plans, and collaborating with an interdisciplinary team across settings.

Travel 25-40% may be required depending on state contracts. You will monitor plans, support behavioral health integration, and document interventions while working independently in diverse environments.

Qualifications

• At least 2 years experience in healthcare or care management.
• RN license must be active and unrestricted in state of practice.
• Valid driver’s license and reliable transportation for job-related travel.
• Understanding of EMR and HIPAA.
• Demonstrated knowledge of community resources.
• Ability to work independently and manage multiple projects.

Responsibilities

• Complete comprehensive member assessments per timelines.
• Develop and implement care coordination plan with the member and care team.
• Conduct telephonic, in-person, or home visits as required.
• Monitor care plan effectiveness and document interventions.
• Maintain ongoing member caseload and outreach.
• Promote integration of services to enhance continuity of care.
• Facilitate interdisciplinary care team meetings and collaboration.
• Educate and motivate change using motivational interviewing and guidelines.
• Assess barriers to care and provide assistance to address concerns.
• May provide consultation to peers as needed.
• Care manager RNs may handle complex cases and medication reconciliation.
• Travel 25-40% as required by state/contractual requirements.

Skills

Time management

Communication

Problem-solving

Self-motivation

Travel readiness

Education

RN license (active)

Valid driver’s license

Tools

EMR systems (HIPAA)

Microsoft Office

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.

• 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).

Molina Healthcare offers a competitive benefits and compensation package.

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $23.76 - $51.49 / HOURLY

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.