Overview
Join the team as a Care Manager (RN) at Molina Healthcare. This role focuses on assessing, coordinating, and integrating care across the continuum for members with high need potential, including behavioral health and long-term care, to ensure outcomes are medically appropriate and cost-effective.
Responsibilities
Complete comprehensive assessments of members within regulated timelines and determine eligibility for case management based on clinical judgment, health changes, psychosocial wellness, and assessment triggers.
Develop and implement a case management plan in collaboration with the member, caregiver, physician, and other healthcare professionals to address needs and goals.
Conduct face-to-face or home visits as required.
Monitor the care plan, document interventions and goal achievement, and suggest changes as needed.
Maintain an ongoing member caseload for regular outreach and management.
Promote integration of services including behavioral health and long-term services and supports to enhance continuity of care.
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 barriers to care and provide coordination and assistance to address concerns.
Travel locally as needed (5-10%).
RNs provide consultation, recommendations, and education to non-RN case managers.
RNs may be assigned cases with complex medical conditions and medication regimens; conduct medication reconciliation when needed.
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/behavioral health settings.
Required License, Certification, Association : Active, unrestricted State RN license in good standing; valid driver’s license with good driving record and reliable transportation; ability to drive within applicable state/locality.
Preferred Education : Bachelor’s Degree in Nursing.
Preferred Experience : 3-5 years in case management, disease management, managed care, or medical/behavioral health settings.
Preferred License, Certification, Association : Active, unrestricted Certified Case Manager (CCM).
To all current Molina employees: 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.