JOB
DESCRIPTION
Job
Summary
Molina Healthcare
Services (HCS) works with members, providers and multidisciplinary
team members to assess, facilitate, plan and coordinate an
integrated delivery of care across the continuum, including
behavioral health and long term care, for members with high need
potential. HCS staff work to ensure that patients progress toward
desired outcomes with quality care that is medically appropriate
and cost-effective based on the severity of illness and the site of
service.
KNOWLEDGE / SKILLS / ABILITIES
Completes comprehensive assessments of members
per regulated timelines and determines who may qualify for case
management based on clinical judgment, changes in member's health
or psychosocial wellness, and triggers identified in the
assessment.
Develops and implements a case
management plan in collaboration with the member, caregiver,
physician and / or other appropriate healthcare professionals and
member's support network to address the member needs and
goals.
Conducts face-to-face or home visits as
required.
Performs ongoing monitoring of the
care plan to evaluate effectiveness, document interventions and
goal achievement, and suggest changes accordingly.
Maintains ongoing member case load for regular outreach
and management.
Promotes integration of
services for members including behavioral health care and long term
services and supports / home and community to enhance the continuity
of care for Molina members.
Facilitates
interdisciplinary care team 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.
25- 40% local
travel required.
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.
JOB
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 or behavioral health settings.
Required License, Certification,
Association
Active, unrestricted
State Registered Nursing (RN) license 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.
Preferred
Education
Bachelor's Degree in
Nursing
Preferred
Experience
3-5 years in case
management, disease management, managed care or medical or
behavioral health settings.
Preferred License,
Certification, Association
Active, unrestricted
Certified Case Manager (CCM)
To all current Molina employees :
If you are interested in applying for this position, please apply
through the intranet job listing.
Molina
Healthcare offers a competitive benefits and compensation package.
Molina Healthcare is an Equal Opportunity Employer (EOE)
M / F / D / V.
#PJHS
#LI-AC1
Pay Range : $26.41 - $59.21 /
HOURLY
on geographic location, work experience, education and / or skill
level.
Care Manager Spanish • RENTON, WA, US