Overview Opportunity for a Texas licensed RN to join Molina to work with our Medicaid members in the Dallas, TX service delivery area. Hours are Monday – Friday, 8 AM – 5 PM CST. Mileage is reimbursed as part of our benefits package. 50-75% travel required.
Responsibilities Conduct face-to-face meetings with members in their homes and complete assessments needed to determine eligible services.
Complete face-to-face or home visits as required.
Develop and implement a case management plan, including a waiver service plan, with the member, caregiver, physician and/or other appropriate healthcare professionals and the member's support network.
Monitor the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes as needed.
Promote integration of services for members, including behavioral health and long-term services and supports, to enhance continuity of care.
Assess medical necessity and authorize appropriate waiver services; evaluate covered benefits and advise on funding sources.
Coordinate interdisciplinary care team meetings for approval or denial of services and informal ICT collaboration.
Use motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
Identify barriers to care and provide care coordination to address psychosocial, financial and medical obstacles.
Identify critical incidents and develop prevention plans to ensure member health and welfare.
Provide consultation and education to non-RN case managers; work with members who have complex medical conditions and medication regimens; conduct medication reconciliation when needed.
Qualifications Required Education
Graduate from an Accredited School of Nursing
Required Experience
At least 1 year of experience with persons with disabilities/chronic conditions and Long Term Services & Supports; 1-3 years in case management, disease management, managed care or medical/behavioral health settings.
Active, unrestricted State Registered Nursing license (RN) 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 if field work is required.
State Specific Requirements
Virginia: Must have at least one year of experience working directly with individuals with Substance Use Disorders
Preferred Education
Bachelor\'s Degree in Nursing
3-5 years in case management, disease management, managed care or medical/behavioral health settings.
1 year experience with populations who receive waiver services.
Preferred License, Certification, Association
Active and unrestricted Certified Case Manager (CCM)
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 - $51.49 / HOURLY
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.