Care Manager / Case Manager (RN)
New
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Molina HealthcareHealthcare
Source API remote eligibility restrictions: United States, Pacific Standard Time hoursFull-TimeManager
Salary not disclosed
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Job Details
- Experience
- At least 2 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.
- Required Skills
- Microsoft OfficeHIPAA
Requirements
- At least 2 years of experience in health care, preferably care management, or experience in a medical or behavioral health setting, or an equivalent combination of relevant education and experience.
- Active, unrestricted Registered Nurse (RN) license in the state of practice.
- Valid, unrestricted driver's license, reliable transportation, and adequate auto insurance for job-related travel, unless otherwise required by law.
- Understanding of electronic medical records (EMR) and HIPAA.
- Knowledge of community resources.
- Proficiency with Microsoft Office and applicable software, and ability to navigate online portals and databases.
- Certified Case Manager (CCM) preferred.
Responsibilities
- Complete comprehensive member assessments within regulated timelines and determine care management eligibility using clinical judgment and assessment triggers.
- Develop care coordination plans with members, caregivers, physicians, other health care professionals, and support networks.
- Conduct telephonic, face-to-face, or home visits as required.
- Monitor care plans, document interventions and goal achievement, and recommend changes.
- Maintain an ongoing member caseload for regular outreach and management.
- Coordinate behavioral health, LTSS, and home and community resources to support continuity of care.
- Facilitate interdisciplinary care team meetings and collaboration.
- Use motivational interviewing and Molina clinical guideposts to educate and support members.
- Assess barriers to care and coordinate assistance to address member concerns.
- Handle complex member cases and medication regimens, including medication reconciliation as needed.
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