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Remote Case Manager (RN) - must reside in south central Illinois

Lensa

Olney (IL)

Remote

Full time

Yesterday

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Job summary

A leading healthcare provider is seeking a Remote Case Manager (RN) to work with Medicare members in south central Illinois. The role involves conducting assessments, developing care plans, and collaborating with healthcare teams to ensure quality care. Ideal candidates will have experience in managed care and a strong clinical background. The position offers competitive pay and requires an active RN license.

Qualifications

1-3 years in case management or managed care settings.
Graduate from an accredited School of Nursing.

Responsibilities

Conducts comprehensive assessments and develops case management plans.
Monitors and evaluates effectiveness of care plans.
Facilitates interdisciplinary care team meetings.

Skills

Assessment

Case Management

Motivational Interviewing

Clinical Judgment

Education

Bachelor's Degree in Nursing

Tools

Microsoft Office Suite

Remote Case Manager (RN) - must reside in south central Illinois

Be among the first 25 applicants 2 days ago

Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

Job Description

Opportunity for Illinois licensed RN to join Molina as a Remote Case Manager working with our Medicare members in south central Illinois (Marion, Richland, Wabash, White, and Jefferson counties). You will complete assessments telephonically with the member to determine the types of services and resources they are eligible to receive. Preference will be given to applicants with experience in managed care organizations (MCO) like Molina, but well-seasoned RNs with a strong clinical background will also be considered. While the position is primarily telephonic, occasional home visits may be required for members nearby. Hours are Monday – Friday, 8 AM – 5 PM CST.

Solid experience with Microsoft Office Suite, especially Outlook, Excel, and Teams, is necessary, along with confidence in navigating multiple programs to complete documentation.

Job Summary

Molina Healthcare Services (HCS) collaborates with members, providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate integrated care across the continuum, including behavioral health and long-term care, for members with high potential needs. HCS staff aim to ensure patients progress toward desired outcomes with quality, medically appropriate, and cost-effective care based on illness severity and service site.

Knowledge/Skills/Abilities

Conducts comprehensive assessments of members within regulated timelines, determining eligibility for case management based on clinical judgment, health changes, psychosocial wellness, and assessment triggers.
Develops and implements case management plans collaboratively with members, caregivers, physicians, and other healthcare professionals to meet member needs and goals.
Performs face-to-face or home visits as needed.
Monitors and evaluates the effectiveness of care plans, documents interventions, and adjusts goals accordingly.
Maintains a regular caseload for outreach and management.
Promotes service integration, including behavioral health and long-term services/supports, to enhance continuity of care.
Facilitates interdisciplinary care team meetings and collaboration.
Uses motivational interviewing and clinical guideposts to educate, support, and motivate members.
Assesses barriers to care and provides coordination and assistance to address concerns.
Requires 25-40% local travel.
Provides consultation, recommendations, and education to non-RN case managers.
Handles cases involving complex medical conditions and medication regimens.
Conducts medication reconciliation when necessary.

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/behavioral health settings.

Required License, Certification, Association

Active, unrestricted State RN license in good standing. Valid driver’s license with a good record and reliable transportation are required.

Preferred Education

Bachelor's Degree in Nursing

Preferred Experience

3-5 years in relevant healthcare settings.

Preferred License, Certification, Association

Active, unrestricted CCM certification.

Interested Molina employees should apply through the intranet job listing. Molina offers competitive benefits and compensation. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $27.73 - $54.06/hourly. Actual compensation may vary based on location, experience, education, and skills.

Additional Details