Registered Nurse Care Manager Remote with Field Travel in Norfolk, Suffolk or Middlesex County

Molina Healthcare; Waltham (MA); Remote; USD 70,000 - 90,000; Full time

Job summary

Molina Healthcare is seeking an RN Case Manager to coordinate care for members in the Massachusetts area. This role involves comprehensive assessments, interdisciplinary collaboration, and developing tailored care plans to meet member needs. Ideal candidates will have a valid MA RN license and experience in case management, with bilingual skills in Spanish or Chinese preferred. Additionally, a competitive benefits package is offered.

Qualifications

• Active, unrestricted State Registered Nursing (RN) license in good standing.
• 1-3 years in case management, disease management, managed care or medical/behavioral health settings.
• Valid driver's license with a good driving record.

Responsibilities

• Completes comprehensive assessments of members to determine case management eligibility.
• Develops and implements case management plans with interdisciplinary teams.
• Conducts face-to-face visits and monitors care plans for effectiveness.

Skills

Case Management

Assessment Skills

Care Coordination

Bilingual Skills (Spanish or Chinese)

Education

Bachelor's Degree in Nursing

Graduate from an Accredited School of Nursing

Job description

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.

This position will support our Senior Whole Health business.Senior Whole Health by Molina Healthcare (“SWH”) is a community-based health care organization with national operations support delivering government funded health plans for members who reside in Massachusetts.We are looking for Candidates with a MA RN licensure.Candidates with case management andHome-basedexperienceare highly preferred.Bilingual candidates that speakSpanish or Chineseare encouraged to apply to support our diverse communities!

Work hours: Monday - Friday 8:00am - 4:30pm EST

Remote with field travel within Norfolk/ Suffolk/ Middlesex counties depending on enrollment

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.
• 25- 40% local travel required.
• 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.

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 case management, disease management, managed care or medical or behavioral health settings.

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.