Care Manager, LTSS (RN)

For this position we are seeking a (RN)

Registered Nurse who must live and have a current active

unrestricted RN license in the state of MI.

This

position will support our MMP (Medicaid Medicare Population) will

be supporting DSNP. This position will have a case load and manage

members enrolled in this program. We are looking for Registered

Nurses who have experience working with manage care population

and / or case management role. Excellent computer skills and

diligence are especially important to multitask between systems,

talk with members on the phone, and enter accurate contact notes.

This is a fast-paced position and productivity is important. This

position requires field work doing assessments with members face to

face in homes.

TRAVEL in the field to do member

visits in the surrounding areas will be required : Detroit

MI

Travel will be up to 50% of the time

(Mileage is reimbursed)

Schedule – Monday thru

Friday 830 AM to 5 PM EST (No weekends or Holidays)

JOB DESCRIPTION Job Summary

Provides

support for care management / care coordination long-term services

and supports specific activities and collaborates with

multidisciplinary team coordinating integrated delivery of member

care across the continuum for members with high-need potential.

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 member assessments within regulated

timelines, including in-person home visits as required.

Facilitates comprehensive waiver enrollment and disenrollment

processes.

• Develops and implements care plans,

including a waiver service plan in collaboration with members,

caregivers, physicians and / or other appropriate health care

professionals and member support network to address the member

needs and goals.

plan to evaluate effectiveness, document interventions and goal

achievement, and suggest changes accordingly.

integration of services for members including behavioral health

care and long-term services and supports (LTSS) and home and

community resources to enhance continuity of care.

Assesses for medical necessity and authorizes all appropriate

waiver services.

appropriately regarding funding sources.

interdisciplinary care team (ICT) meetings for approval or denial

of services and informal ICT collaboration.

motivational interviewing and Molina clinical guideposts to

educate, support and motivate change during member

contacts.

care coordination and assistance to members to address

psycho / social, financial, and medical obstacles

concerns.

prevention plans to assure member health and welfare.

May provide consultation, resources and recommendations to peers as

needed.

cases and medication regimens.

conduct medication reconciliation as needed.

estimated local travel may be required (based upon

state / contractual

requirements).

Required Qualifications

least 2 years experience in health care, including at least 1 year

experience in care management, managed care, and / or experience in a

medical or behavioral health setting, and at least 1 year of

experience working with persons with disabilities, chronic

conditions, substance abuse disorders, and long-term services and

supports (LTSS), or equivalent combination of relevant education

and experience.

active and unrestricted in state of practice.

unrestricted driver's license, reliable transportation, and

adequate auto insurance for job related travel requirements, unless

otherwise required by law.

proactively and demonstrate detail-oriented work.

Demonstrated knowledge of community resources.

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

working with diverse populations and various personalities and

personal situations.

with minimal supervision and demonstrate

self-motivation.

communication, and ability to remain calm in high-pressure

situations.

professional relationships.

and prioritization skills, and ability to focus on multiple

projects simultaneously and adapt to change.

problem-solving and critical-thinking skills.

verbal and written communication skills.

Office suite / applicable software program(s)

proficiency.

year of experience working directly with individuals with substance

use disorders.

Preferred Qualifications

Certified Case Manager (CCM).

populations that receive waiver services.

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 :

$26.41 - $51.49 / HOURLY

from posting based on geographic location, work experience,

education and / or skill level.