Care Manager (RN) (Maternal Child Experience Required) - REMOTE - OH ONLY

Remote Full-time
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. Essential Job Duties • 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). Required Qualifications • 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. • Registered Nurse (RN). License must 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. • Understanding 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. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to work independently, with minimal supervision and self-motivation. • Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving, and critical-thinking skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications • Certified Case 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 Apply tot his job
Apply Now →

Similar Jobs

[Hiring] Respiratory Therapist / Registered Respiratory Therapist @Roshal Health

Remote Full-time

Endoscopy Pre-Screening Registered Nurse, Remote MO

Remote Full-time

Lead Global Sales Head (Remote)

Remote Full-time

Hybrid Respiratory Therapist (0.6-0.8 FTE available) Evenings/Nights

Remote Full-time

[Hiring] Telephone Triage Registered Nurse @Rock House

Remote Full-time

Utilization Management RN US - Remote (Any location)

Remote Full-time

Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management)

Remote Full-time

[Hiring] Registered Nurse (RN) Triage Opportunity @Trinity Health

Remote Full-time

[Hiring] Preservice Review Nurse @UnitedHealth Group

Remote Full-time

RN (Registered Nurse) *Awesome Pay*

Remote Full-time

Children’s Book Illustrator Needed (Ages 4–8 | Hawaiian-Themed Story)

Remote Full-time

**Experienced Virtual Customer Care Representative – Community Management and Customer Relations**

Remote Full-time

Game Developer – Remote

Remote Full-time

Application Architect, Salesforce

Remote Full-time

**Experienced Customer Success Specialist – Tech Support (Starting at $20 per hour, hybrid/mostly work at home)**

Remote Full-time

Part Time - Health Care - Research Assistant

Remote Full-time

Crisis Hotline Counselor (Afternoon/Overnight)

Remote Full-time

Quality Assurance Manager - Caption & Testing Services (100% Remote)

Remote Full-time

Associate Creative Director (ACD), Art Director (Remote)

Remote Full-time

Chief Compliance Officer, Risk and Insurance

Remote Full-time
← Back to Home