RN Care Manager / Case Manager
M
Molina HealthcareManaged care
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
- Have at least 2 years of health care experience, preferably in care management or a medical or behavioral health setting, or an equivalent combination of relevant education and experience.
- Hold an active, unrestricted Registered Nurse (RN) license in the state of practice.
- Have compact licensure.
- Hold a valid, unrestricted driver's license and have reliable transportation and adequate auto insurance for job-related travel, unless otherwise required by law.
- Understand electronic medical records (EMR) and HIPAA.
- Demonstrate knowledge of community resources.
- Be able to work independently with minimal supervision and adapt to varied settings and situations.
- Have strong verbal and written communication, problem-solving and critical-thinking skills.
- Have time-management and prioritization skills and be able to manage multiple projects.
- Be proficient with Microsoft Office or applicable software and able to navigate online portals and databases.
- Certified Case Manager (CCM) is preferred.
Responsibilities
- Complete comprehensive member assessments within regulated timelines and determine care management needs using clinical judgment and assessment triggers.
- Develop care coordination plans with members, caregivers, physicians, other health care professionals and member support networks.
- Conduct telephonic, face-to-face or home visits as required.
- Monitor care plans, document interventions and goal achievement, and recommend changes as needed.
- Maintain an ongoing member caseload for outreach and management.
- Coordinate behavioral health, long-term services and supports, and home and community resources.
- Facilitate interdisciplinary care team meetings and collaboration.
- Use motivational interviewing and Molina clinical guideposts to educate and support members.
- Assess barriers to care and assist members with addressing concerns.
- Handle complex cases and medication regimens, and conduct medication reconciliation as needed.
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