Remote Care Manager (RN) - MUST LIVE IN TEXAS

Molina Healthcare · Texas, TX, United States

FULL TIME

Job Description

Three of the positions are open to RNs with at least two years of experience in in Behavioral Health or Substance Abuse Disorder in any type of setting; the other three should have at least two years of experience working in ICU, CCU, or Emergency Department. The members supported by these care managers have complex mental health diagnosis and/or complex health diagnosis and comorbidities. Most of the responsibilities will be managed telephonically, but there may be rare instances where meeting with a member in person may be needed. Hours are Monday – Friday, 8 AM – 5 PM in your time zone. Preference will be given to RNs who have been employed by another managed care organization as a case manager. Bilingual is a plus.

Solid experience with Microsoft Office Suite is necessary, especially with Outlook, Excel, Teams, and One Note.

Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments.

Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
Maintains ongoing member caseload for regular outreach and management.
Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
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.
Care manager RNs may be assigned complex member cases and medication regimens.
Care manager RNs may conduct medication reconciliation as needed.
25-40% estimated local travel may be required (based upon state/contractual requirements). At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
Registered Nurse (RN). Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA).
Demonstrated knowledge of community resources.
Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
Ability to work independently, with minimal supervision and self-motivation.
Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.

Certified Case Manager (CCM).

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Company	Molina Healthcare
Location	Texas, TX, United States
Type	FULL TIME
Niche	healthcare

Explore 1M+ Live Opportunities.

Remote Care Manager (RN) - MUST LIVE IN TEXAS

Job Description