Hospice Oversight Case Manager (RN) California

Molina Healthcare; Burbank (CA); On-site; USD 80,000 - 100,000; Full time

Job summary

An established industry player is seeking a dedicated Hospice Oversight Case Manager (RN) to join their team in Burbank, CA. This role involves assessing and coordinating care for members with complex needs, ensuring they receive quality, cost-effective healthcare. The ideal candidate will collaborate with a multidisciplinary team to develop tailored care plans, conduct assessments, and promote continuity of care. This position offers a chance to make a significant impact in the lives of patients while working in a supportive and dynamic environment.

Qualifications

• 1-3 years in case management or managed care settings.
• Active, unrestricted State Registered Nursing (RN) license required.

Responsibilities

• Completes comprehensive assessments of members for case management.
• Develops and implements case management plans with healthcare professionals.

Skills

Case Management

Disease Management

Behavioral Health

Motivational Interviewing

Medication Reconciliation

Education

Bachelor's Degree in Nursing

Graduate from an Accredited School of Nursing

Job description

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Join to apply for the Hospice Oversight Case Manager (RN) California role at Molina Healthcare

HOSPICE OVERSIGHT CASE MANAGER (REGISTERED NURSE)

Job Description

Job Summary

Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

Knowledge/Skills/Abilities

• Completes comprehensive assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified in the assessment.
• Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.
• Conducts face-to-face or home visits as required.
• Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member case load for regular outreach and management.
• Promotes integration of services for members including behavioral health care and long term services and supports/home and community to enhance the continuity of care for Molina members.
• Facilitates interdisciplinary care team 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.
• RNs provide consultation, recommendations and education as appropriate to non-RN case managers.
• RNs are assigned cases with members who have complex medical conditions and medication regimens
• RNs conduct medication reconciliation when needed.
• Occasional travel to other Molina offices or hospice facilities as requested, may be required. This can vary based on the individual State Plan.
  
  

Job Qualifications

Required Education

Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.

Required Experience

1-3 years in case management, disease management, managed care or medical or behavioral health settings.

Required License, Certification, Association

Active, unrestricted State Registered Nursing (RN) license in good standing.

Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

Preferred Education

Bachelor's Degree in Nursing

Preferred Experience

3-5 years in hospice case management and managed care.

Previous work experience reviewing and managing hospice case records

Fraud, waste and abuse auditing experience

Exceptional knowledge of California hospice facilities

Working knowledge of Utilization Management processes

Preferred License, Certification, Association

Active, unrestricted Certified Case Manager (CCM)

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

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

Pay Range: $30.37 - $59.21 / HOURLY

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

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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