Field Care Manager (Rn) -(Mclean County)

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

Job summary

Molina Healthcare in Illinois is seeking an experienced Registered Nurse to join our care management team. The role focuses on coordinating member care across the continuum, completing assessments, and developing individualized care plans with the member and care network.

The RN will conduct home visits or telephonic outreach, monitor progress, address barriers, and facilitate interdisciplinary team collaboration. Travel of 25-40% is expected based on state and contract requirements.

Qualifications

• RN license active in state of practice.
• At least 2 years healthcare experience, care management preferred.
• Valid driver's license and reliable transportation for travel.
• Understanding of EMR and HIPAA.
• Strong communication and time-management skills.

Responsibilities

• Complete comprehensive member assessments per regulated timelines and determine eligibility for care management.
• Develop and implement care coordination plan with member, caregiver, physician and care team.
• Conduct telephonic, face-to-face or home visits as required.
• Monitor care plan effectiveness and document interventions and milestones.
• Maintain ongoing member caseload for regular outreach and management.
• Promote integration of services across behavioral health, LTSS, and home/community resources.
• Facilitate interdisciplinary care team (ICT) meetings and collaboration.
• Educate and motivate change using motivational interviewing.
• Assess barriers to care and provide needed assistance.
• May provide consultation to peers; may conduct medication reconciliation.

Skills

Care coordination

Communication

Time management

Problem solving

Independent work

EMR knowledge

HIPAA compliance

Travel flexibility

Team collaboration

Education

RN license

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).

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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.