Remote RN Care Manager – Medicare Care Coordination

Molina Healthcare; Post Falls (ID); Remote; USD 36,000 - 82,000; Full time

Job summary

Molina Healthcare is seeking a remote RN Care Manager for our Washington State Health Plan. This telephonic case management role operates on Pacific Standard Time hours with a preference for WA state candidates.

No travel, no direct patient care, weekends, holidays, or night work required. The RN will support Medicare members through coordinated care management, collaborating with a multidisciplinary team to achieve quality, cost-effective outcomes while navigating EMR systems and HIPAA

Qualifications

• At least 2 years experience in health care, preferably in care management or related setting.
• RN license must be active and unrestricted in state of practice.
• Valid and unrestricted driver’s license and reliable transportation.
• Understanding of EMR and HIPAA.
• Demonstrated knowledge of community resources.
• Ability to work proactively and with attention to detail.
• Ability to work across diverse settings and populations.
• Ability to work independently with minimal supervision.
• Strong communication and time-management skills.
• Proficiency with Microsoft Office and online portals/databases.

Responsibilities

• Completes comprehensive assessments of members per timelines and identifies who may qualify for care management.
• Develops and implements care coordination plan with member and care team.
• Performs telephonic, in-person, or home visits as required.
• Monitors care plan effectiveness and documents interventions and outcomes.
• Maintains ongoing member caseload with regular outreach.
• Promotes integration of services across behavioral health, LTSS, and community resources.
• Facilitates ICT meetings and collaboration.
• Uses motivational interviewing to educate and motivate change.
• Assesses barriers to care and provides coordination to address concerns.
• May provide consultation to peers as needed.
• May conduct medication reconciliation for complex cases.
• 25-40% local travel may be required based on state/contractual requirements.

Skills

RN license

EMR experience

HIPAA knowledge

Time management

Communication skills

Independent work

Travel readiness

Microsoft Office

Driver's license

Education

RN license (active)

CCM (preferred)

Tools

EMR system

Microsoft Office

Online portals & databases

Job description

Molina Healthcare is seeking a remote RN Care Manager for our Washington State Health Plan. This telephonic case management role operates on Pacific Standard Time hours with a preference for WA state candidates.

No travel, no direct patient care, weekends, holidays, or night work required. The RN will support Medicare members through coordinated care management, collaborating with a multidisciplinary team to achieve quality, cost-effective outcomes while navigating EMR systems and HIPAA