RN Care Manager: Coordinated Care & Outcomes

Molina Healthcare Inc; Biloxi (MS); On-site; USD 55,000 - 75,000; Full time

Job summary

Molina Healthcare Inc. is seeking a Registered Nurse to support care management and coordinate care across the delivery continuum. You will work with a multidisciplinary team to ensure member progress toward outcomes and contribute to cost-effective care strategies.

Responsibilities include assessments, care coordination planning, and travel to member sites as needed. Strong communication, EMR/HIPAA knowledge, and ability to work independently are essential.

Qualifications

• Minimum 2 years of experience in health care, preferably in care management.
• RN license active and unrestricted in state of practice.
• Valid driver's license, reliable transportation for job-related travel.
• Understanding of EMR and HIPAA.
• Strong communication and time-management skills.
• Ability to work independently and with minimal supervision.

Responsibilities

• Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment.
• Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other health care professionals and member support network.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, LTSS, and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• May provide consultation, resources and recommendations to peers as needed.
• Care manager RNs may be assigned complex member cases and medication regimens.
• Care manager RNs may conduct medication reconciliation as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Skills

Communication

Multidisciplinary collaboration

Patient advocacy

Care coordination

Time management

Education

Registered Nurse (RN) license

Active and unrestricted license in state of practice

Tools

EMR systems

HIPAA knowledge

Nurse care management software

Job description

Molina Healthcare Inc. is seeking a Registered Nurse to support care management and coordinate care across the delivery continuum. You will work with a multidisciplinary team to ensure member progress toward outcomes and contribute to cost-effective care strategies.

Responsibilities include assessments, care coordination planning, and travel to member sites as needed. Strong communication, EMR/HIPAA knowledge, and ability to work independently are essential.