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Care Manager (RN)
Care Manager (RN)Molina Healthcare • FRESNO, CA, US
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Care Manager (RN)

Care Manager (RN)

Molina Healthcare • FRESNO, CA, US
Hace más de 30 días
Tipo de contrato
  • A tiempo completo
Descripción del trabajo
  • California residency required
  • in one of the following counties : Sacramento , San Diego, Los

    Angeles, Riverside or San Bernardino

    County.

    JOB DESCRIPTION Job Summary

    Provides

    support for care management / care coordination activities and

    collaborates with multidisciplinary team coordinating integrated

    delivery of member care across the continuum. Strives to ensure

    member progress toward desired outcomes and contributes to

    overarching strategy to provide quality and cost-effective member

    care.

    Essential Job

    Duties

    • Completes comprehensive
    • assessments of members per regulated timelines and determines who

      may qualify for care management based on clinical judgment, changes

      in member health or psychosocial wellness and triggers identified

      in assessments.

    • Develops and implements care
    • coordination plan in collaboration with member, caregiver,

      physician and / or other appropriate health care professionals and

      member support network to address member needs and

      goals.

    • Conducts telephonic, face-to-face or home visits
    • as required.

    • Performs ongoing monitoring of care plan
    • to evaluate effectiveness, document interventions and goal

      achievement, and suggest changes accordingly.

    • Maintains
    • ongoing member caseload for regular outreach and

      management.

    • Promotes integration of services for
    • members including behavioral health, long-term services and

      supports (LTSS), and home and community resources to enhance

      continuity of care.

    • Facilitates interdisciplinary care
    • team (ICT) meetings and informal ICT collaboration.

      Uses motivational interviewing and Molina clinical guideposts to

      educate, support and motivate change during member

      contacts.

    • Assesses for barriers to care, provides care
    • coordination and assistance to member to address

      concerns.

    • May provide consultation, resources and
    • recommendations to peers as needed.

    • Care manager RNs
    • may be assigned complex member cases and medication

      regimens.

    • Care manager RNs may conduct medication
    • reconciliation as needed.

    • some local travel may
    • be required (based upon state / contractual

      requirements).

      Required Qualifications

    • At
    • least 2 years experience in health care, preferably in care

      management, or experience in a medical and / or behavioral health

      setting, or equivalent combination of relevant education and

      experience.

    • Registered Nurse (RN). License must be
    • active and unrestricted in state of practice.

    • Valid and
    • unrestricted driver's license, reliable transportation, and

      adequate auto insurance for job related travel requirements, unless

      otherwise required by law.

    • Understanding of the
    • electronic medical record (EMR) and Health Insurance Portability

      and Accountability Act (HIPAA).

    • Demonstrated knowledge
    • of community resources.

    • Ability to operate proactively
    • and demonstrate detail-oriented work.

    • Ability to work
    • within a variety of settings and adjust style as needed - working

      with diverse populations, various personalities and personal

      situations.

    • Ability to work independently, with minimal
    • supervision and self-motivation.

    • Responsiveness in all
    • forms of communication, and ability to remain calm in high-pressure

      situations.

    • Ability to develop and maintain
    • professional relationships.

    • Excellent time-management
    • and prioritization skills, and ability to focus on multiple

      projects simultaneously and adapt to change.

    • Excellent
    • problem-solving, and critical-thinking skills.

    • Strong
    • verbal and written communication skills.

    • Microsoft
    • Office suite / applicable software program proficiency, 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

      Pay Range : $30.37 - $59.21 / HOURLY

    • Actual compensation may vary from posting based on
    • geographic location, work experience, education and / or skill

      level.

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