RN Care Manager Remote with field travel in WA state

Molina Healthcare; Orlando (FL); Remote; USD 80,000 - 100,000; Full time

Job summary

A healthcare services provider in Florida is seeking a Case Manager. The role involves case management for members, requiring a WA RN license and experience in high-demand environments. Ideal candidates will have experience in Medicare/Medicaid and MS Suite skills. This position offers remote work with local travel. A Bachelor's degree in Nursing is preferred, and bilingual candidates are encouraged to apply.

Benefits

Competitive benefits package

Equal Opportunity Employer

Qualifications

• 1-3 years in case management, disease management, or medical settings required.
• Active, unrestricted WA RN licensure required.
• Preferred: 3-5 years in relevant settings.

Responsibilities

• Conduct comprehensive assessments and develop case management plans.
• Conduct home visits as required.
• Monitor care plans and promote integration of services.

Skills

Case Management experience

Knowledge of MS Suite

Organizational skills

Analytical thinking

Bilingual (Spanish)

Education

Graduate from an Accredited School of Nursing

Bachelor's Degree in Nursing (preferred)

Tools

MS 365

Job description

JOB DESCRIPTION

Job Summary

Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

This position will be supporting our Washington State Medicare plan. We are seeking a candidate with previous Case Management experience and a WA RN licensure. The candidate should have proficient knowledge of MS Suite, organized and analytical thinking. Experience with Medicare/Medicaid, MS 365 and familiarity with claims is highly preferred. The Case Manager must be able to work in a high-volume environment. Bilingual candidates that speak Spanish are encouraged to apply. Further details to be discussed during our interview process.

Remote with 10% travel to member's home or facility

Work schedule Monday through Friday 8:30 AM to 5:00 PM PST.

WA RN licensure required.

KNOWLEDGE/SKILLS/ABILITIES

• Completes comprehensive assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified in the assessment.

• Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.

• Conducts face-to-face or home visits as required.

• Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.

• Maintains ongoing member case load for regular outreach and management.

• Promotes integration of services for members including behavioral health care and long term services and supports/home and community to enhance the continuity of care for Molina members.

• Facilitates interdisciplinary care team 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.

• 10% local travel required.

• RNs provide consultation, recommendations and education as appropriate to non-RN case managers.

• RNs are assigned cases with members who have complex medical conditions and medication regimens

• RNs conduct medication reconciliation when needed.

JOB QUALIFICATIONS

Required Education

Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.

Required Experience

1-3 years in case management, disease management, managed care or medical or behavioral health settings.

Required License, Certification, Association

Active, unrestricted State Registered Nursing (RN) license in good standing.

Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

Preferred Education

Bachelor's Degree in Nursing

Preferred Experience

3-5 years in case management, disease management, managed care or medical or behavioral health settings.

Preferred License, Certification, Association

Active, unrestricted Certified Case Manager (CCM)

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $26.41 - $61.79 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.