Care Manager / Case Mgr (RN) Remote (WA Pref) Must Have Compact Licensure

Molina Healthcare•Portland, OR

6d•$26 - $59•Remote

About The Position

Molina Healthcare is hiring a remote RN Care Manager for its Washington State Health Plan. Candidates located in Washington are preferred but not required. The position works Pacific Standard Time hours and supports Medicare members through telephonic case management and transition-of-care functions. The posting states there is no current travel, direct patient care, weekend, holiday, or night work, while also noting that 25–40% estimated local travel may be required based on state or contractual requirements. The role supports care management and care coordination activities and collaborates with a multidisciplinary team to coordinate integrated member care across the continuum. The Care Manager works to help members progress toward desired outcomes and contributes to the delivery of quality, cost-effective care. Previous RN care management experience at a managed care organization is highly desired.

Requirements

At least 2 years of health care experience, preferably in care management or in a medical or behavioral health setting, or an equivalent combination of relevant education and experience.
Active, unrestricted Registered Nurse (RN) license in the state of practice; the role posting also specifies compact licensure in its title.
Valid, unrestricted driver's license, reliable transportation, and adequate auto insurance for job-related travel requirements, unless otherwise required by law.
Understanding of electronic medical records (EMR) and the Health Insurance Portability and Accountability Act (HIPAA).
Demonstrated knowledge of community resources.
Ability to work proactively and with attention to detail.
Ability to work in varied settings and adjust style when working with diverse populations, personalities, and personal situations.
Ability to work independently with minimal supervision and demonstrate self-motivation.
Responsiveness in all forms of communication and ability to remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Excellent time-management and prioritization skills, ability to manage multiple projects simultaneously, and adaptability to change.
Excellent problem-solving and critical-thinking skills.
Strong verbal and written communication skills.
Proficiency with Microsoft Office and applicable software, and ability to navigate online portals and databases.

Nice To Haves

Previous RN care management experience at a managed care organization is highly desired.
Certified Case Manager (CCM).

Responsibilities

Complete comprehensive member assessments within regulated timelines and use clinical judgment, changes in health or psychosocial wellness, and assessment triggers to determine potential care management eligibility.
Develop and implement care coordination plans in collaboration with members, caregivers, physicians, other appropriate health care professionals, and member support networks.
Conduct telephonic, face-to-face, or home visits as required.
Monitor care plans, evaluate effectiveness, document interventions and goal achievement, and recommend changes as appropriate.
Maintain an ongoing member caseload for regular outreach and management.
Promote integration of behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
Facilitate interdisciplinary care team meetings and informal interdisciplinary collaboration.
Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate members during contacts.
Assess barriers to care and provide coordination and assistance to address member concerns.
Provide consultation, resources, and recommendations to peers as needed.
Manage complex member cases and medication regimens when assigned.
Conduct medication reconciliation as needed.