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Case Manager (RN) (Must Reside in CA)

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Job Summary Molina Healthcare Services (HCS) collaborates with members, providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate integrated care across the continuum, including behavioral health and long-term care, for members with high-need potential. The staff aims to ensure patients progress toward desired outcomes with quality, medically appropriate, and cost-effective care based on illness severity and service site.

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.

Knowledge/Skills/Abilities

Completes comprehensive assessments of members per regulated timelines and determines eligibility for case management based on clinical judgment, health or psychosocial changes, and assessment triggers.

Develops and implements a case management plan collaboratively with the member, caregiver, healthcare professionals, and support network to meet the member's needs and goals.

Conducts face-to-face or home visits as required.

Monitors the care plan continuously to evaluate effectiveness, document interventions, and suggest modifications.

Maintains an ongoing member caseload for regular outreach and management.

Promotes service integration, including behavioral health and long-term services, to enhance continuity of care.

Facilitates interdisciplinary care team meetings and informal collaboration.

Uses motivational interviewing and Molina clinical guideposts to educate, support, and motivate members.

Assesses barriers to care and provides coordination and assistance to address concerns.

25-40% local travel required.

RNs provide consultation, recommendations, and education to non-RN case managers.

RNs handle cases with members having complex medical conditions and medication regimens.

Conducts medication reconciliation as 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/behavioral health settings.

Required License, Certification, Association Active, unrestricted State RN license in good standing. Valid driver's license with a good driving record and reliable transportation.

Preferred Education Bachelor's Degree in Nursing.

Preferred Experience 3-5 years in relevant healthcare settings.

Preferred License, Certification, Association Active, unrestricted CCM certification.

Preferred Languages English/Korean (if applicable).

Current Molina employees interested in this position should apply through the intranet.

Molina Healthcare offers competitive benefits and compensation. We are an EOE M/F/D/V.

Pay Range: $26.41 - $51.49/hour

Additional Details

Seniority level: Mid-Senior level

Employment type: Full-time

Job function: Health Care Provider

Industries: Human Resources Services

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