Overview Molina Healthcare has partnered with iHire to recruit for an opening in Massachusetts. This role supports care management and care coordination activities, collaborates with a multidisciplinary team, and coordinates integrated delivery of member care. The goal is to ensure member progress toward outcomes while contributing to quality and cost-effective care.
Location: Remote position with 25-50% travel across specified counties in Massachusetts based on case load and residence. Hours: Monday – Friday, 8:00 AM to 5:00 PM EST.
Position will support Molina One Care Services in Massachusetts. MA RN licensure is required. Candidates with case management and home health experience are highly preferred. Bilingual candidates are encouraged to apply to support diverse communities.
Compensation range and benefits are described in the job posting; this is an Equal Opportunity Employer (EOE) M/F/D/V.
Essential Job Duties Complete comprehensive assessments of members within regulated timelines to determine eligibility for care management based on clinical judgment, health changes, or psychosocial needs identified in assessments.
Develop and implement a care coordination plan in collaboration with the member, caregiver, physician, and other health care professionals and support networks to address needs and goals.
Conduct telephonic, face-to-face, or home visits as required.
Monitor the care plan ongoingly to evaluate effectiveness, document interventions and goal achievement, and suggest changes as needed.
Maintain an ongoing member caseload for regular outreach and management.
Promote integration of services (behavioral health, LTSS, and home/community resources) to enhance continuity of care.
Facilitate interdisciplinary care team (ICT) meetings and collaboration.
Use motivational interviewing and Molina clinical guidelines to educate, support, and motivate change during member contacts.
Assess barriers to care and provide coordination and assistance to address concerns.
Provide consultation, resources, and recommendations to peers as needed.
Care manager RNs may be assigned complex member cases and medication regimens; may conduct medication reconciliation as needed.
Estimated local travel: 25-40% based on state/contractual requirements.
Required Qualifications At least 2 years of experience in health care, preferably in care management or an equivalent combination of relevant education and experience (medical and/or behavioral health settings).
Registered Nurse (RN) with an active and unrestricted license in the state of practice.
Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job-related travel, unless otherwise required by law.
Understanding of electronic medical records (EMR) and HIPAA.
Knowledge of community resources and ability to operate proactively with detail-oriented work.
Ability to work across diverse settings with diverse populations and personalities; ability to work independently with minimal supervision and self-motivation.
Strong communications skills (verbal and written) and ability to remain calm in high-pressure situations.
Ability to develop and maintain professional relationships and manage multiple projects with excellent time management and prioritization.
Proficiency with Microsoft Office and ability to navigate online portals and databases.
Preferred Qualifications Certified Case Manager (CCM).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.