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

Lensa; Olney (IL); Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a dedicated Remote Case Manager (RN) to provide essential support for Medicare members in south central Illinois. This role involves conducting telephonic assessments and developing tailored care plans to ensure members receive the necessary services and resources. The successful candidate will collaborate with healthcare professionals and manage ongoing caseloads, promoting integrated services to enhance continuity of care. With a focus on quality and cost-effective solutions, this position offers a unique opportunity to make a significant impact on patient outcomes while enjoying the flexibility of remote work.

Benefits

Competitive Benefits

Flexible Work Hours

Remote Work Opportunity

Qualifications

• 1-3 years in case management or managed care settings.
• Active RN license in Illinois required.

Responsibilities

• Conduct assessments and develop care plans for members.
• Monitor care plans and manage ongoing member caseloads.
• Facilitate interdisciplinary team meetings.

Skills

Assessment Skills

Care Plan Development

Clinical Judgment

Motivational Interviewing

Microsoft Office Suite

Education

Bachelor's Degree in Nursing

Graduate from an accredited School of Nursing

Tools

Microsoft Outlook

Microsoft Excel

Microsoft Teams

Job description

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

Opportunity for Illinois licensed RN to join Molina as a Remote Case Manager working with Medicare members in south central Illinois (Marion, Richland, Wabash, White, and Jefferson counties). You will complete assessments telephonically to determine the types of services and resources members are eligible for. Preference will be given to applicants with experience in managed care organizations like Molina, but we also consider experienced RNs with strong clinical backgrounds. This position is primarily telephonic, with occasional home visits near your location. Hours are Monday – Friday, 8 AM – 5 PM CST.

Solid experience with Microsoft Office Suite, especially Outlook, Excel, and Teams, is required. You should be confident in navigating multiple programs to complete necessary documentation.

Job Summary

Molina Healthcare Services (HCS) collaborates with members, providers, and multidisciplinary teams to assess, plan, and coordinate care across the continuum, including behavioral health and long-term care, for members with high needs. Our goal is to ensure quality, medically appropriate, and cost-effective care that improves patient outcomes.

Knowledge/Skills/Abilities

• Conduct comprehensive assessments within regulated timelines and identify candidates for case management based on clinical judgment, health changes, psychosocial factors, and assessment triggers.
• Develop and implement care plans in collaboration with members, caregivers, physicians, and healthcare professionals to meet member needs and goals.
• Perform face-to-face or home visits as required.
• Monitor care plans regularly to evaluate effectiveness, document interventions, and update goals.
• Manage ongoing member caseloads for outreach and care management.
• Promote integrated services, including behavioral health and long-term supports, to enhance continuity of care.
• Facilitate interdisciplinary team meetings and collaborate with care teams.
• Use motivational interviewing and Molina’s clinical guidelines to educate and support members.
• Identify barriers to care and assist members in overcoming them.
• Travel up to 25-40% locally.
• Provide consultation, recommendations, and education to non-RN case managers.
• Handle cases with complex medical conditions and medication regimens, including 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 behavioral health settings.

Required Licenses/Certifications

Active, unrestricted RN license in Illinois in good standing. Valid driver’s license with a good driving record and reliable transportation.

Preferred Education

Bachelor's Degree in Nursing.

Preferred Experience

3-5 years in relevant healthcare settings.

Additional Notes

If you are a current Molina employee interested in this position, please apply through the intranet. We offer competitive benefits and are an Equal Opportunity Employer (EOE) M/F/D/V. Pay range: $27.73 - $54.06/hour. Actual compensation may vary based on location, experience, education, and skills.