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RN Transition of Care Coach Field Care in Richland, Pasco,or Kennewick

RN Transition of Care Coach Field Care in Richland, Pasco,or Kennewick

Molina HealthcareRENTON, WA, US
1 day ago
Job type
  • Full-time
Job description

JOB DESCRIPTION

Job Summary

Provides

support for care transition activities. Facilitates transitional

care processes and coordination for member discharge from hospital

admission to all other settings. Strives to ensure that best

possible services are available to members at time of hospital

discharge, and focuses on goal to reduce member readmissions.

Contributes to overarching strategy to provide quality and

cost-effective member care.

We are seeking a

candidate with a WA state RN licensure. Candidates with case

management and hospital- facility experience is highly preferred.

Candidates must have a h istory of working with

providers and members to provide care coordination, find resources,

managing care needs, advocating, and assessing

needs. Additional skills required strong communication skills,

problem solving and must be organized. Bilingual

candidates are encouraged to apply. Further details to be discussed

during our interview process.

Remote with field

travel to hospital facilities in the cities of

Richland, Pasco, and

Kennewick

Work schedule : Monday- Friday : 8 : 00am- 5 : 00pm PST.

RN WA licensure required

Essential Job Duties

  • Follows member throughout a 30 day program

that starts at hospital admission and continues oversight through

transitions from acute setting to all other settings, including

nursing facility placement / private home, with the goal of reduced

readmissions.

  • Ensures safe and appropriate transitions
  • by collaborating with the hospital discharge planner, as well as

    collaborating with hospitalists, outpatient providers, facility

    staff, and family / support network.

  • Ensures member
  • transitions to setting with adequate caregiving and functional

    support, as well as medical and medication oversight

    support.

  • Works with participating ancillary providers,
  • public agencies or other service providers to make sure necessary

    services and equipment are in place for safe transition.

  • Conducts face-to-face visits of all members while in the hospital
  • and, home visits high-risk members post-discharge as

    needed.

  • Coordinates care and reassesses member needs
  • using the Coleman Care Transition model post-discharge.

    Educates and supports member focusing on seven primary areas

    (Transition of Care Pillars) : medication management, use of

    personal health record, follow-up care, signs and symptoms of

    worsening condition, nutrition, functional needs and or home and

    community-based services, and advance directives.

  • 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.

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

  • Provides
  • consultation, recommendations and education as appropriate to

    non-behavioral health care managers.

  • 40-50% local
  • travel may be required (based upon state / contractual

    requirements).

    Required

    Qualifications

  • At least 2 years
  • experience in health care, with at least 1 year of experience in

    hospital discharge planning, care management 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.

  • Knowledge of or experience
  • using the Care Transitions Intervention (CTI) or similar

    model.

  • Background in discharge planning and / or home
  • health.

  • Demonstrated knowledge of community
  • resources.

  • Proactive and detail-oriented.
  • 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 demonstrate self-motivation.

  • Responsive 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.

  • Excellent verbal and written communication skills.
  • Microsoft Office suite / other applicable software program(s)

    proficiency.

    Preferred

    Qualifications

  • Transitions of care
  • sub-specialty certification and / or Certified Case Manager

    (CCM).

  • Hospital discharge planning or home health
  • experience.

    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 - $59.21 / HOURLY

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

    level.

    Create a job alert for this search

    Transition Of Care Rn • RENTON, WA, US

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