Care Manager - RN/Licensed BH Professionals - Travel Required

Molina Healthcare; Iowa (LA); On-site; USD 29,756 - 64,485; Full time

Benefits offered by this job

Mileage reimbursement

Competitive benefits package

Job summary

A leading healthcare organization is seeking a Care Manager in Louisiana to conduct assessments for Medicaid members. The role involves developing care plans, monitoring progress, and working within a team to ensure integrated delivery of care. Candidates must have at least 2 years of healthcare experience and a valid RN license. Proficiency in Microsoft Office is necessary. This position offers competitive pay and requires a mix of field and remote work.

Qualifications

• At least 2 years of healthcare experience, including care management.
• Active and unrestricted Registered Nurse (RN) license.
• Valid driver's license and reliable transportation required.
• Knowledge of community resources.
• Ability to work with diverse populations.

Responsibilities

• Conduct face-to-face and telephonic visits with Medicaid members.
• Complete assessments to determine service needs.
• Manage member care until discharge.
• Develop and implement care plans with the healthcare team.
• Monitor care plans for effectiveness and necessary adjustments.

Skills

Communication skills

Detail-oriented work

Problem-solving skills

Time management

Proficient in Microsoft Office Suite

Critical thinking

Education

Bachelor's or Master's degree in social services or related field

Tools

Microsoft Office Suite

Job description

JOB DESCRIPTION

Opportunity for either an experienced Care Manager who is Bachelors or Masters trained in a social services field OR an Iowa licensed RN to join the LTSS team with our Iowa Health Plan. Responsibilities include conducting face-to-face and telephonic visits with our Medicaid members, completing assessments to determine the types of services we need to provide, and managing their care until they are discharged from your service. The ideal candidate will have experience as a Care Manager within a managed care organization (MCO) like Molina or have experience working with IHH assessments. Hours are Monday – Friday, 8 AM – 5 PM CST; 75% of your time will be spent in the field and the remainder you will work from your home office. Mileage is reimbursed as part of our benefit package.

Solid experience with Microsoft Office Suite is necessary, especially with Outlook, Excel, and Teams as well as being confident in moving between different programs to complete the necessary forms and documentation.

Due to contractual requirements with Iowa, we are unable to hire LPN/LVNs for this role.

Job Summary

Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. 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 member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services 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 and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• Collaborates with licensed care managers/leadership as needed or required.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience 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. Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, 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.
• Demonstrated knowledge of community resources.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work independently, with minimal supervision and self-motivation.
• Ability to demonstrate responsiveness in all forms of communication, and 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), License must be active and unrestricted in state of practice.
• Experience working with populations that receive waiver services.

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

Pay Range: $21.6 - $46.81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.