Care Manager (RN) (Hendry County, FL)

Molina Talent Acquisition; Florida; On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

Molina Healthcare, Inc. is seeking a Registered Nurse care manager to support care coordination across the continuum. You will assess members, develop care plans with an interdisciplinary team, and conduct home visits or telephonic outreach to ensure progress toward desired outcomes.

The role involves coordinating behavioral health and LTSS services, facilitating ICT meetings, and navigating EMR/HIPAA protocols. Travel 25–40% is expected depending on state requirements.

Qualifications

• Minimum 2 years in health care, preferably care management or related setting
• Active RN license in state of practice
• Valid driver’s license, reliable transportation for travel
• Understanding of EMR and HIPAA compliance
• Strong ability to work independently and manage multiple tasks
• Excellent verbal and written communication skills

Responsibilities

• Complete comprehensive member assessments within regulated timelines and determine qualification for care management
• Develop and implement care coordination plans with members, families, and care teams
• Conduct telephonic, in-person, or home visits as required
• Monitor care plans for effectiveness and update as needed
• Maintain ongoing member caseload with proactive outreach
• Promote service integration across behavioral health and LTSS
• Facilitate ICT meetings and collaborate with team members
• Provide education and motivational support to members
• Identify barriers to care and address them with resources
• May provide consultation and guidance to peers
• Care manager RNs may handle complex cases and conduct medication reconciliation
• Travel 25–40% depending on state/contract requirements

Skills

Care coordination

Interdisciplinary collaboration

Motivational interviewing

Documentation & recordkeeping

Time management

Strong communication

Microsoft Office proficiency

Education

Registered Nurse (RN) license

CCM certification (preferred)

Tools

EMR systems

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).

Molina Healthcare offers a competitive benefits and compensation package.

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