Care Manager (RN)

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.

Pay Range : $25.08 - $51.49 / HOURLY

• Actual compensation may vary from posting based on

geographic location, work experience, education and / or skill

level.