Telephonic RN Care Manager

Molina Healthcare; Long Beach (CA); Remote; USD 75,000 - 95,000; Full time

Job summary

Molina Healthcare is seeking a Registered Nurse to support our Medicaid population in Utah. This role involves case management responsibilities and providing quality care to members, ensuring they meet their healthcare goals. A collaborative approach with other healthcare professionals is essential, along with strong multitasking and computer skills. This remote position requires occasional office visits for training and team meetings.

Benefits

Competitive benefits package

Qualifications

• 1-3 years in case management or medical/behavioral health settings required.
• Active State Registered Nursing (RN) license in good standing needed.
• Valid driver's license with reliable transportation necessary.

Responsibilities

• Manage members enrolled in Medicaid and coordinate care.
• Develop and implement case management plans with healthcare professionals.
• Conduct regular assessments and maintain ongoing member case load.

Skills

Excellent computer skills

Multitasking

Motivational interviewing

Education

Graduate from an Accredited School of Nursing

Bachelor's Degree in Nursing

Job description

We are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of UT

This position will support our Medicaid Population that is live within the state of UT. This position will have a case load and manage members enrolled in this program. We are looking for Registered Nurses who have experience working with manage care population and/or case management role. Excellent computer skills and diligence are especially important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important.

This is a Remote position, home office with internet connectivity of high speed required. (must be able to go into the office for team meetings and/or training events)

Schedule: Monday thru Friday 8:00AM to 4:30 PM MST

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.

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.
• 25- 40% 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

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.

About the company

Molina Healthcare is a managed care company headquartered in Long Beach, California, United States.

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