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Case Manager (RN) (Must Reside in CA)
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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, medically appropriate, and cost-effective care based on the severity of illness and the site of service.
Job Responsibilities
Complete comprehensive assessments of members within regulated timelines and determine eligibility for case management based on clinical judgment, health or psychosocial changes, and assessment triggers.
Develop and implement a case management plan collaboratively with the member, caregiver, physician, and other healthcare professionals to address needs and goals.
Conduct face-to-face or home visits as required.
Monitor and evaluate the effectiveness of the care plan, document interventions, and suggest modifications.
Maintain a regular caseload for outreach and management.
Promote service integration, including behavioral health and long-term services, to enhance continuity of care.
Facilitate interdisciplinary team meetings and collaborate informally with the care team.
Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate members.
Identify barriers to care and assist members in addressing concerns.
Travel locally up to 40% of the time.
Provide consultation, recommendations, and education to non-RN case managers.
Manage cases with members who have complex medical conditions and medication regimens.
Conduct medication reconciliation when needed.
Qualifications Required Education Graduate from an accredited nursing school; Bachelor's Degree in Nursing preferred.
Required Experience 1-3 years in case management, disease management, managed care, or health settings.
Required Licenses & Certifications Active, unrestricted RN license in California; valid driver’s license with a good record and reliable transportation.
Preferred Education Bachelor's Degree in Nursing.
Preferred Experience 3-5 years in relevant health settings.
Preferred Certifications Certified Case Manager (CCM).
Languages English; Korean language skills are a plus.
Additional Information Position is full-time, mid-senior level, with a pay range of $26.41 - $51.49 per hour. 25-40% local travel required. Molina offers a competitive benefits package and is an EOE employer.
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Case Manager (RN) (Must Reside in CA)
role at
ClickJobs.io
Get AI-powered advice on this job and more exclusive features.
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, medically appropriate, and cost-effective care based on the severity of illness and the site of service.
Job Responsibilities
Complete comprehensive assessments of members within regulated timelines and determine eligibility for case management based on clinical judgment, health or psychosocial changes, and assessment triggers.
Develop and implement a case management plan collaboratively with the member, caregiver, physician, and other healthcare professionals to address needs and goals.
Conduct face-to-face or home visits as required.
Monitor and evaluate the effectiveness of the care plan, document interventions, and suggest modifications.
Maintain a regular caseload for outreach and management.
Promote service integration, including behavioral health and long-term services, to enhance continuity of care.
Facilitate interdisciplinary team meetings and collaborate informally with the care team.
Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate members.
Identify barriers to care and assist members in addressing concerns.
Travel locally up to 40% of the time.
Provide consultation, recommendations, and education to non-RN case managers.
Manage cases with members who have complex medical conditions and medication regimens.
Conduct medication reconciliation when needed.
Qualifications Required Education Graduate from an accredited nursing school; Bachelor's Degree in Nursing preferred.
Required Experience 1-3 years in case management, disease management, managed care, or health settings.
Required Licenses & Certifications Active, unrestricted RN license in California; valid driver’s license with a good record and reliable transportation.
Preferred Education Bachelor's Degree in Nursing.
Preferred Experience 3-5 years in relevant health settings.
Preferred Certifications Certified Case Manager (CCM).
Languages English; Korean language skills are a plus.
Additional Information Position is full-time, mid-senior level, with a pay range of $26.41 - $51.49 per hour. 25-40% local travel required. Molina offers a competitive benefits package and is an EOE employer.
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