Overview RN Transition of Care - Care Manager (Texas). Hybrid telephonic and face-to-face visits within hospitals supporting TX Medicaid members who have recently been admitted. Requires a current active unrestricted RN license in Texas. Travel to designated hospitals in El Paso, Hidalgo County, and San Antonio, TX with mileage reimbursement. Schedule: Monday through Friday, 8:00 AM to 5:00 PM CST (no weekends or holidays).
Responsibilities Complete comprehensive assessments of members per regulated timelines and determine eligibility for case management based on clinical judgment, changes in health or psychosocial status, and triggers identified in the assessment.
Develop and implement a case management plan in collaboration with the member, caregiver, physician and other appropriate healthcare professionals and the member's support network to address needs and goals.
Conduct 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/home and community 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 for barriers to care and provide care coordination to address concerns.
Travel locally 25-40% of the time for member visits.
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 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 Registered Nursing (RN) license in good standing.
Valid driver’s license with a good driving record and ability to drive with reliable transportation.
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).
Compensation & Benefits Pay Range: $26.41 - $51.49 / HOURLY. Actual compensation may vary based on geographic location, work experience, education and/or skill level.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.