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Case Manager - Troy, United States - Molina Healthcare
Description
JOB DESCRIPTION
For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of MI
Case Manager RN will work in remote and field setting supporting Medicaid Behavioral health population.
Excellent computer skills and attention to detail are very 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. Local travel into our office may be required.Home office with internet connectivity of high speed required.
This is remote position, but candidate must be willing to come to the Troy MI office for team meeting and/or trainings.
Schedule:
Monday thru Friday 8:30AM to 5:00PM
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.
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.
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.
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.
Bachelor's Degree in Nursing
Preferred Experience
3-5 years in case management, disease management, managed care or medical or behavioral health settings.
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:
$ $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.