Overview
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.
Responsibilities
- Follows the member through a 30-day program starting at hospital admission and continuing through transitions from the acute setting to other settings (e.g., nursing facility placement and private home) with the goal of reducing readmissions.
- Ensure safe and appropriate transitions by collaborating with hospital discharge planners, hospitalists, outpatient providers, facility staff, and family/support networks as needed or at the member’s request.
- Ensure member transitions to a setting with adequate caregiving, functional support, and medical/medication oversight as required.
- Work with participating ancillary providers, public agencies, or other service providers to ensure necessary services and equipment are in place for a safe transition.
- Conduct face-to-face visits of all members while in the hospital and home visits of high-risk members post-discharge.
- Coordinate care and reassess member needs using the Coleman Care Transitions Model recommended post-discharge timeline.
- Educate and support the member focusing on seven priority areas (ToC Pillars): medication management, use of personal health records, follow-up care, signs and symptoms of worsening condition, nutrition, functional needs and Home and Community-based Services, and advance directives.
- Use motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
- Assess barriers to care and provide care coordination to address concerns.
- Facilitate interdisciplinary care team meetings and informal ICT collaboration.
- 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.
Qualifications
Required Education
Graduate from an Accredited School of Nursing. Bachelor’s Degree in Nursing preferred.
Required Experience
1-3 years hospital discharge planning or home health.
Required License, Certification, Association
Active, unrestricted State Registered Nursing (RN) license in good standing. Must have a valid driver’s license with a good driving record and be able to drive within the applicable state or locality with reliable transportation.
Preferred Education
Bachelor’s Degree in Nursing
Preferred Experience
3-5 years hospital discharge planning or home health.
Preferred License, Certification, Association
Active, unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager (CCM)
Job Details
- Work schedule: M - F Pacific Business Hours
- Candidates can live anywhere in the USA but must work PACIFIC hours. California or West Coast USA Residents preferred
- Remote, no travel required
- Employment type: Full-time
- Seniority level: Entry level
- Job function: Health Care Provider
- Industries: Hospitals and Health Care and Medical Practices
Compensation and Notice
Pay Range: $26.41 - $61.79 / HOURLY
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.