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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 care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
Job Description 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 meet the member's needs and goals.
Conduct face-to-face or home visits as required.
Monitor the care plan regularly to evaluate effectiveness, document interventions, and adjust as needed.
Maintain an ongoing caseload for regular outreach and management.
Promote service integration, including behavioral health and long-term services, to enhance continuity of care.
Facilitate interdisciplinary care team meetings and collaboration.
Use motivational interviewing and clinical guideposts to educate, support, and motivate members.
Assess barriers to care and provide coordination and assistance to address concerns.
Travel locally 25-40% of the time.
Provide consultation, recommendations, and education to non-RN case managers.
Manage cases with complex medical conditions and medication regimens.
Conduct medication reconciliation as needed.
Qualifications:
Education:
Graduate from an accredited nursing school; Bachelor's Degree preferred.
Experience:
1-3 years in case management, disease management, managed care, or health settings; 3-5 years preferred.
Licenses/Certifications:
Active, unrestricted RN license; Valid driver’s license and reliable transportation; CCM certification preferred.
Languages:
English required; Korean preferred.
Additional Information: Position involves local travel; RNs provide consultation and education; cases involve complex conditions. Compensation ranges from $26.41 to $51.49 hourly. Apply through the intranet if you are a current Molina employee.
Job Details
Seniority level: Mid-Senior level
Employment type: Full-time
Job function: Healthcare Provider
Industry: Human Resources Services
Molina Healthcare is an EOE. Benefits and compensation are competitive.
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Case Manager (RN) (Must Reside in CA)
role at
ClickJobs.io
3 days ago Be among the first 25 applicants
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 care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
Job Description 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 meet the member's needs and goals.
Conduct face-to-face or home visits as required.
Monitor the care plan regularly to evaluate effectiveness, document interventions, and adjust as needed.
Maintain an ongoing caseload for regular outreach and management.
Promote service integration, including behavioral health and long-term services, to enhance continuity of care.
Facilitate interdisciplinary care team meetings and collaboration.
Use motivational interviewing and clinical guideposts to educate, support, and motivate members.
Assess barriers to care and provide coordination and assistance to address concerns.
Travel locally 25-40% of the time.
Provide consultation, recommendations, and education to non-RN case managers.
Manage cases with complex medical conditions and medication regimens.
Conduct medication reconciliation as needed.
Qualifications:
Education:
Graduate from an accredited nursing school; Bachelor's Degree preferred.
Experience:
1-3 years in case management, disease management, managed care, or health settings; 3-5 years preferred.
Licenses/Certifications:
Active, unrestricted RN license; Valid driver’s license and reliable transportation; CCM certification preferred.
Languages:
English required; Korean preferred.
Additional Information: Position involves local travel; RNs provide consultation and education; cases involve complex conditions. Compensation ranges from $26.41 to $51.49 hourly. Apply through the intranet if you are a current Molina employee.
Job Details
Seniority level: Mid-Senior level
Employment type: Full-time
Job function: Healthcare Provider
Industry: Human Resources Services
Molina Healthcare is an EOE. Benefits and compensation are competitive.
#J-18808-Ljbffr