RN Care Manager - Waiver Program

For this position we are seeking a Registered

Nurse who lives in OHIO and must be licensed for the state of

OHIO.

This position will support our MMP

(Medicaid Medicare Population) with members on Waiver program. This

position will have a case load and manage members enrolled in this

program. We are looking for Registered Nurses who have experience

working with manage care population and / or case management role.

Excellent computer skills and diligence are especially 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. This position requires field work doing

assessments with members face to face in homes.

TRAVEL in the field to do member visits in the surrounding

areas will be required : Columbus OH - (Mileage is

reimbursed)

Schedule – Monday thru Friday 800 AM

to 5 PM EST (No weekends or Holidays

JOB

DESCRIPTION Job Summary

Provides support for

care management / care coordination long-term services and supports

specific activities and collaborates with multidisciplinary team

coordinating integrated delivery of member care across the

continuum for members with high-need potential. Strives to ensure

member progress toward desired outcomes and contributes to

overarching strategy to provide quality and cost-effective member

care.

Essential Job

Duties

• Completes comprehensive

member assessments within regulated timelines, including in-person

home visits as required.

waiver enrollment and disenrollment processes.

and implements care plans, including a waiver service plan in

collaboration with members, caregivers, physicians and / or other

appropriate health care professionals and member support network to

address the member needs and goals.

monitoring of care plan to evaluate effectiveness, document

interventions and goal achievement, and suggest changes

accordingly.

members including behavioral health care and long-term services and

supports (LTSS) and home and community resources to enhance

continuity of care.

authorizes all appropriate waiver services.

covered benefits and advises appropriately regarding funding

sources.

meetings for approval or denial of services and informal ICT

collaboration.

Molina clinical guideposts to educate, support and motivate change

during member contacts.

and provides care coordination and assistance to members to address

psycho / social, financial, and medical obstacles

concerns.

prevention plans to assure member health and welfare.

May provide consultation, resources and recommendations to peers as

needed.

cases and medication regimens.

conduct medication reconciliation as needed.

estimated local travel may be required (based upon

state / contractual

requirements).

Required Qualifications

least 2 years experience in health care, including at least 1 year

experience in care management, managed care, and / or experience in a

medical or behavioral health setting, and at least 1 year of

experience working with persons with disabilities, chronic

conditions, substance abuse disorders, and long-term services and

supports (LTSS), or equivalent combination of relevant education

and experience.

active and unrestricted in state of practice.

unrestricted driver's license, reliable transportation, and

adequate auto insurance for job related travel requirements, unless

otherwise required by law.

proactively and demonstrate detail-oriented work.

Demonstrated knowledge of community resources.

to work within a variety of settings and adjust style as needed -

working with diverse populations and various personalities and

personal situations.

with minimal supervision and demonstrate

self-motivation.

communication, and ability to remain calm in high-pressure

situations.

professional relationships.

and prioritization skills, and ability to focus on multiple

projects simultaneously and adapt to change.

problem-solving and critical-thinking skills.

verbal and written communication skills.

Office suite / applicable software program(s)

proficiency.

year of experience working directly with individuals with substance

use disorders.

Preferred Qualifications

Certified Case Manager (CCM).

populations that receive waiver services.

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

from posting based on geographic location, work experience,

education and / or skill level.