Transition of Care Coach (RN) Remote with Field Travel in Seattle WA

Molina Healthcare; Seattle (WA); Hybrid; USD 80,000 - 100,000; Full time

Job summary

Molina Healthcare is seeking a Transition of Care Coach (RN) to provide care coordination for members with high needs, ensuring tailored support across healthcare settings. This role involves both remote work and field travel in Seattle, focusing on improving patient outcomes through effective transition practices.

Qualifications

• Active RN licensure in Washington State required.
• 1-3 years hospital discharge planning or home health experience preferred.
• Bilingual candidates encouraged to apply.

Responsibilities

• Asses and facilitate member care coordination.
• Conduct face-to-face visits for care transitions.
• Collaborate with hospital discharge planners for safe transitions.

Skills

Collaboration

Motivational interviewing

Care coordination

Education and support

Education

Graduate from an Accredited School of Nursing

Bachelor's Degree in Nursing preferred

Job description

Transition of Care Coach (RN) Remote with Field Travel in Seattle WA

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Transition of Care Coach (RN) Remote with Field Travel in Seattle WA

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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.

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.

We are seeking a candidate with a WA state RN licensure. Candidates with case management and hospital- facility experience is highly preferred. Bilingual candidates are encouraged to apply. Further details to be discussed during our interview process.

Remote with field travel to hospital facilities in Seattle WA- King County.

Work schedule: Monday- Friday: 8:00am- 5:00pm PST.

RN WA licensure required

Knowledge/Skills/Abilities

• Follows member throughout a 30-day program that starts at hospital admission and continues through transitions from the acute setting to other settings, including nursing facility placement and private home, with the goal of reduced readmissions.
• Ensures safe and appropriate transitions by collaborating with hospital discharge planners, as well as with hospitalists, outpatient providers, facility staff, and family/support network, as needed or at the request of member.
• Ensures member transitions to a setting with adequate caregiving and functional support, as well as medical and medication oversight as required.
• Works with participating ancillary providers, public agencies, or other service providers to make sure necessary services and equipment are in place for a safe transition.
• Conducts face-to-face visits of all members while in the hospital and home visits of high-risk members post-discharge.
• Coordinates care and reassesses member's needs using the Coleman Care Transitions Model recommended post-discharge timeline.
• Educates and supports member focusing on seven primary areas (ToC Pillars): medication management, use of personal health record, follow up care, signs and symptoms of worsening condition, nutrition, functional needs and or Home and Community-based Services, and advance directives.
• 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.
• Facilitates interdisciplinary care team meetings and informal ICT collaboration.
• 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 will conduct medication reconciliation when needed.
• 40-50% local travel required.
  
  

Job Qualifications

Required Education

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

Required Experience

1-3 years hospital discharge planning or home health.

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 hospital discharge planning or home health.

Preferred License, Certification, Association

Active, unrestricted Transitions of Care Sub-Specialty Certification and/or 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.

#PJHPO

Pay Range: $26.41 - $59.21 / HOURLY

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

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  Hospitals and Health Care

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