Remote RN Care Manager – Medicare

Molina Healthcare; Naperville (IL); Remote; USD 39,000 - 74,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

Molina Healthcare is hiring an Illinois-licensed RN Case Manager to support Medicare members from a remote work setup in Illinois. The role involves telephonic assessments, care coordination and collaboration with a multidisciplinary team to ensure quality, cost-effective care.

Some in-person visits may occur as needed. Preferred candidates have prior Medicare experience in managed care, strong MS Office skills, and the ability to navigate EMR/HIPAA systems.

Qualifications

• At least 2 years in health care, care management or related settings.
• RN license active and unrestricted in state of practice.
• Valid driver's license with reliable transportation for travel requirements.
• Knowledge of EMR and HIPAA.
• Knowledge of community resources.
• Able to work independently and stay organized.
• Strong written and verbal communication skills.
• Proficient with MS Office and navigating online portals.

Responsibilities

• Complete comprehensive member assessments per timelines to determine care management eligibility.
• Develop and implement care coordination plan with member, caregivers and health professionals.
• Conduct telephonic, face-to-face or home visits as required.
• Monitor care plan, document interventions and adjust as needed.
• Maintain ongoing member caseload with regular outreach.
• Promote integration of behavioral health, LTSS and community resources.
• Facilitate ICT meetings and collaborate with team.
• Educate and motivate change using motivational interviewing.
• Identify barriers and assist members to address concerns.
• May provide consultation to peers as needed.
• May handle complex cases and medication reconciliation.
• 25-40% local travel may be required.

Skills

RN license

Healthcare experience

Driver's license

EMR/ HIPAA

Community resources

Multitasking/ time management

Verbal & written communication

MS Office

Travel readiness

Cross-functional teamwork

Education

RN license

CCM certification

Tools

Outlook

Excel

Teams

EMR software

Job description

Molina Healthcare is hiring an Illinois-licensed RN Case Manager to support Medicare members from a remote work setup in Illinois. The role involves telephonic assessments, care coordination and collaboration with a multidisciplinary team to ensure quality, cost-effective care.

Some in-person visits may occur as needed. Preferred candidates have prior Medicare experience in managed care, strong MS Office skills, and the ability to navigate EMR/HIPAA systems.