JOB DESCRIPTION
Job Summary
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.
This position
will support our Molina One Care Services business in
Massachusetts. We are looking for a candidate with a MA RN
licensure. Candidates with case management and home health are
highly preferred. Bilingual candidates are encouraged to apply
to support our diverse communities!
Hours :
Monday - Friday 8 : 00 AM to 5 : 00 PM EST
Remote
position with 25-50% field travel in Bristol, Essex, Hampden,
Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, OR Worcester
member case load based on where you
reside.
Essential Job
Duties
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.
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.
visits as required.
of care plan to evaluate effectiveness, document interventions and
goal achievement, and suggest changes
accordingly.
for regular outreach and management.
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.
and Molina clinical guideposts to educate, support and motivate
change during member contacts.
barriers to care, provides care coordination and assistance to
member to address concerns.
consultation, resources and recommendations to peers as
needed.
member cases and medication regimens.
manager RNs may conduct medication reconciliation as
needed.
required (based upon state / contractual
requirements).
Required
Qualifications
years experience in health care, preferably in care management, or
experience in a medical and / or behavioral health setting, or
equivalent combination of relevant education and
experience.
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.
of the electronic medical record (EMR) and Health Insurance
Portability and Accountability Act (HIPAA).
Demonstrated knowledge of community resources.
Ability to operate proactively and demonstrate detail-oriented
work.
settings and adjust style as needed - working with diverse
populations, various personalities and personal
situations.
minimal supervision and self-motivation.
Responsiveness in all forms of communication, and ability to remain
calm in high-pressure situations.
develop and maintain professional relationships.
Excellent time-management and prioritization skills, and ability to
focus on multiple projects simultaneously and adapt to
change.
critical-thinking skills.
written communication skills.
suite / applicable software program proficiency, and ability to
navigate online portals and
databases.
Preferred
Qualifications
Manager (CCM).
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
#PJHS
Pay Range : $30.37 - $59.21 /
HOURLY
on geographic location, work experience, education and / or skill
level.
Field Case Manager • FRAMINGHAM, MA, US