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

Lensa; Vernon (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 telephonic assessments and coordinate care for Medicare members in south central Illinois. This role emphasizes quality and cost-effective care through collaboration with multidisciplinary teams. Ideal candidates will have a strong clinical background, experience in managed care, and proficiency in Microsoft Office Suite. Join a forward-thinking organization that values your expertise and offers opportunities for professional growth while making a significant impact in the lives of high-need members.

Qualifications

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

Responsibilities

• Conduct comprehensive assessments and develop care plans.
• Monitor and evaluate effectiveness of care plans.
• Facilitate interdisciplinary team meetings.

Skills

Microsoft Office Suite

Telephonic Assessments

Motivational Interviewing

Education

Bachelor's degree in Nursing

Graduate from accredited nursing school

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). The role involves telephonic assessments to determine eligible services and resources. Preference will be given to applicants with experience in managed care organizations like Molina, but seasoned RNs with strong clinical backgrounds are also considered. The position is primarily telephonic, with occasional home visits near your location. Hours are Monday – Friday, 8 AM – 5 PM CST.

Required skills include solid experience with Microsoft Office Suite, especially Outlook, Excel, and Teams, and the ability to navigate multiple programs efficiently.

Job Summary: Molina Healthcare Services (HCS) collaborates with members, providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate care across the continuum, including behavioral health and long-term care, for high-need members. The focus is on quality, medically appropriate, and cost-effective care, with ongoing evaluation and adjustment of care plans.

Key Responsibilities:

• Complete comprehensive assessments within regulated timelines and identify candidates for case management based on clinical judgment and changes in health or psychosocial factors.
• Develop and implement individualized care plans in collaboration with members, caregivers, and healthcare professionals.
• Conduct face-to-face or home visits as needed.
• Monitor and evaluate the effectiveness of care plans, documenting interventions and outcomes.
• Maintain a caseload with regular outreach and management.
• Promote service integration, including behavioral health and long-term supports, to ensure continuity of care.
• Facilitate interdisciplinary team meetings and collaborate with care teams.
• Use motivational interviewing and clinical guidelines to support member engagement and change.
• Assess barriers to care and assist members in overcoming them.
• Travel up to 25-40% locally.
• Provide consultation and education to non-RN case managers regarding clinical issues.
• Handle cases involving complex medical conditions and medication management, including medication reconciliation when necessary.

Qualifications:

• Graduate from an accredited nursing school; Bachelor's degree preferred.
• 1-3 years of experience in case management, disease management, managed care, or behavioral health.
• Active, unrestricted RN license in Illinois.
• Valid driver's license and reliable transportation.

Preferred qualifications include 3-5 years of relevant experience and a Bachelor's degree in Nursing. The position offers a pay range of $27.73 - $54.06 per hour, depending on experience and location.