RN Care Manager: Driving Coordinated Care

Molina Healthcare, Inc.; Ohio; On-site; USD 65,000 - 90,000; Full time

Job summary

Molina Healthcare, Inc. seeks a registered nurse to support care management and coordinate care across the continuum. You will collaborate with the member, family, physician, and care team to address needs and goals, and conduct assessments within regulatory timelines.

The role involves visits or telephonic contacts, monitoring plans, and promoting integration of services, including behavioral health and LTSS. Proficiency with EMR/HIPAA and Microsoft Office is essential.

Qualifications

• At least 2 years of health care experience in care management or related settings.
• RN license active and unrestricted in state of practice.
• Valid driver’s license, reliable transportation, and adequate auto insurance for job-related travel requirements.
• Understanding of EMR and HIPAA.
• Demonstrated knowledge of community resources.
• Ability to operate proactively and detail-oriented work.
• Ability to work in diverse settings with various populations.
• Ability to work independently with minimal supervision.
• Strong communication skills, both verbal and written.
• Proficiency with Microsoft Office and online portals/databases.

Responsibilities

• Completes comprehensive member assessments within regulated timelines to identify care management eligibility.
• Develops and implements care coordination plans with members, families, physicians and other health professionals.
• Performs telephonic, in-person, or home visits as required.
• Monitors and documents progress of the care plan; evaluates effectiveness and adjusts as needed.
• Maintains ongoing member caseload with regular outreach and follow-up.
• Promotes integration of services, including behavioral health and LTSS, to enhance continuity of care.
• Facilitates ICT meetings and collaboration among care teams.
• Uses motivational interviewing and Molina clinical guidelines to support change.
• Identifies barriers to care and provides coordination and assistance to address concerns.
• May provide consultation and recommendations to peers.
• RN care managers may handle complex cases and med reconciliation.
• Travel 25-40% may be required.

Skills

Care coordination

Communication skills

Time management

Problem-solving

Independent work

Education

Registered Nurse (RN) license

Job description

Molina Healthcare, Inc. seeks a registered nurse to support care management and coordinate care across the continuum. You will collaborate with the member, family, physician, and care team to address needs and goals, and conduct assessments within regulatory timelines.

The role involves visits or telephonic contacts, monitoring plans, and promoting integration of services, including behavioral health and LTSS. Proficiency with EMR/HIPAA and Microsoft Office is essential.