Field Care Manager (Rn) -(Mclean County)

Molina Healthcare; Aurora (IL); On-site; USD 39,000 - 74,000; Full time

Job summary

Molina Healthcare is seeking an RN to provide care management and coordination across the continuum. You will assess member needs, develop integrated care plans, and collaborate with physicians, caregivers, and the care network to improve outcomes and quality of care.

Responsibilities include conducting assessments, coordinating services, and visiting members as needed. Travel up to 40% may be required based on state and contract requirements. Strong EMR/HIPAA knowledge is essential for success.

Qualifications

• Requires RN license active in state of practice.
• Healthcare experience in care management or equivalent.
• Knowledge of EMR systems, HIPAA, and patient privacy is essential.
• Ability to manage multiple tasks with tight timelines.

Responsibilities

• Complete comprehensive member assessments within required timelines.
• Develop and implement care coordination plans with stakeholders.
• Conduct telephonic, in-person, or home visits as needed.
• Monitor care plans, document progress, and adjust interventions.
• Maintain a caseload and outreach for ongoing care coordination.
• Promote integration of services across behavioral health, LTSS, and community resources.
• Facilitate ICT meetings and collaborate with the care team.
• Provide education and support to motivate patient change.

Skills

Communication

Time management

Problem solving

Critical thinking

Interpersonal skills

Independent work

Microsoft Office

EMR HIPAA knowledge

Education

RN license

Tools

EMR systems

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.

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).

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

Pay Range: $27.73 - $54.06 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.