RN Care Manager - Community Well

Job Description

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 OH

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Case Manager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our Community Well population, completing face to face assessments, care plans, and providing education and support to our members.  Excellent computer skills and attention to detail are very 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.

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Home office with internet connectivity of high speed required.

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Schedule : Monday thru Friday 8 : 00AM to 5 : 00PM

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Field Travel - Franklin, Pickaway, Union, Delaware, Madison Counties (Mileage is reimbursed)

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JOB DESCRIPTION Job Summary

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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.

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Essential Job Duties

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• 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.
• 25-40% estimated local travel may be required (based upon state / contractual requirements).

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Required Qualifications

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Preferred Qualifications

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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