Description
**JOB DESCRIPTION**
**Job Summary**
Molina Healthcare Services (HCS) works with members, providers, and multidisciplinary team members to assess, facilitate, plan, and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**This position will support our Senior Whole Health business.** **-Senior Whole Health by Molina-** **is a Managed Long-Term Care (MLTC), and Medicaid Advantage (MAP) plan. These plans streamline the delivery of long-term services to chronically ill or disabled people who are eligible for Medicaid and Medicare.** **We are looking for Registered Nurse Case Managers with strong organizational and time management skills. The Case Manager must have the ability to work in a high-volume environment to better serve our members. Experience with Managed Long Term Care experience (MLTC) is highly preferred.** **-Bilingual candidates encourage to apply.-**
**Remote position within the Tri-state area. (New York, New Jersey, or Connecticut)**
**KNOWLEDGE/SKILLS/ABILITIES**
Completes comprehensive assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified in the assessment.
Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.
Conducts face-to-face or home visits as required.
Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
Maintains ongoing member case load for regular outreach and management.
Promotes integration of services for members including behavioral health care and long-term services and supports/home and community to enhance the continuity of care for Molina members.
Facilitates interdisciplinary care team 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.25- 40% local travel required.
RNs provide consultation, recommendations, and education as appropriate to non-RN case managers.
RNs are assigned cases with members who have complex medical conditions and medication regimens.
RNs conduct medication reconciliation when needed.
**JOB QUALIFICATIONS**
**Required Education**
Graduate from an Accredited School of Nursing. Bachelor's degree in nursing preferred.
**Required Experience**
1-3 years in case management, disease management, managed care or medical or behavioral health settings.
**Required License, Certification, Association**
Active, unrestricted State Registered Nursing (RN) license in good standing.
Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
**Unrestricted RN licensure**
**Preferred Education**
Bachelor's degree in nursing
**Preferred experience**
**Managed Long Term Care experience (MLTC)**
**Case Management experience**
**Home health experience**
**Experience working with the geriatric population.**
**Ability to manage a high case load, up to 225 cases.**
**Must be able to work in a fast pace/high volume environment.**
**Bilingual**
Preferred License, Certification, Association
Active, unrestricted Certified Case Manager (CCM)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $23.76 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Compensation Information:
$23.76 / Hourly - $23.76 / Hourly
Starting At: 23.76 Hourly
Up To: 51.49 Hourly
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