Pediatric Care Manager RN — Care Coordination

Molina Healthcare; Miami (FL); On-site; USD 35,817 - 57,859; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare in Miami seeks an RN with behavioral health experience to support pediatric members and deliver high-quality care.

The role includes comprehensive assessments, care coordination, home visits, and ongoing monitoring of care plans in collaboration with families, physicians and the care team. Travel up to 40% may be required; strong EMR/HIPAA knowledge and communication skills are essential.

Qualifications

• At least 2 years experience in health care, preferably in care management or similar.
• RN with active unrestricted license in the state of practice.
• Valid driver's license and reliable transportation for job-related travel.
• Understanding of EMR and HIPAA.
• Ability to work independently and manage multiple tasks.

Responsibilities

• Completes comprehensive assessments of members per regulated timelines and determines care management eligibility based on clinical judgment and changes in member health or psychosocial wellness.
• Develops and implements care coordination plans with member, caregiver, physician and others to address needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Monitors care plans and documents interventions and progress toward goals.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services across behavioral health, LTSS, and home/community resources.
• Facilitates ICT meetings and collaboration with the care team.
• Uses motivational interviewing and Molina clinical guideposts to support change.
• Assesses barriers to care and provides coordination and assistance.
• May provide consultation and recommendations to peers.

Skills

RN license

Care management

Behavioral health

EMR

HIPAA knowledge

Communication skills

Time management

Driver's license

Education

RN license, active in state of practice

Tools

Microsoft Office

EMR system

Job description

Molina Healthcare in Miami seeks an RN with behavioral health experience to support pediatric members and deliver high-quality care.

The role includes comprehensive assessments, care coordination, home visits, and ongoing monitoring of care plans in collaboration with families, physicians and the care team. Travel up to 40% may be required; strong EMR/HIPAA knowledge and communication skills are essential.