Overview Care Manager at Molina Healthcare. 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 aim to ensure patients progress toward outcomes with quality care that is medically appropriate and cost-effective based on severity of illness and site of service.
Must reside in Iowa.
Responsibilities Complete clinical assessments of members per regulated timelines and determine who may qualify for case management based on clinical judgment, changes in health or psychosocial wellness, and triggers from the assessment.
Develop and implement a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address member needs and goals.
Conduct telephonic, face-to-face or home visits as required.
Perform ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
Maintain an ongoing member caseload for regular outreach and management.
Promote integration of services for members including behavioral health care and long term services and supports to enhance continuity of care for Molina members.
May implement specific Molina wellness programs (e.g., asthma and depression disease management).
Facilitate interdisciplinary care team meetings and informal ICT collaboration.
Use motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
Assess for barriers to care, provide care coordination and assistance to address member concerns.
Collaborate with RN case managers/supervisors as needed; case managers in Behavioral Health and Social Science fields may provide consultation and resources to peers.
Local travel may be required depending on complexity level, state regulations, or location within Molina’s Central Programs unit. 98% telephonic assessments.
Qualifications Required Education
Any of the following: Bachelor\'s or Master\'s Degree (preferably in social science, psychology, gerontology, public health, social work or related).
Required Experience
1-3 years in case management, disease management, managed care or medical or behavioral health settings.
Required License, Certification, Association
If license is required for the job, license must be active, unrestricted and in good standing.
Other Requirements
Must have valid driver’s license with good driving record and be able to drive within applicable state or locality with reliable transportation.
Preferred Experience
3-5 years in case management, disease management, managed care or medical or behavioral health settings.
Preferred License, Certification, Association
Licensed Clinical Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education and Promotion (CHEP), Licensed Professional Counselor (LPC/LPCC), Respiratory Therapist, or Licensed Marriage and Family Therapist (LMFT).
To all current Molina employees: 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: $22.80 - $46.81 / HOURLY
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Job Details Seniority level: Entry level
Employment type: Full-time
Job function: Health Care Provider
Industries: Hospitals and Health Care
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