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

Molina Healthcare•Long Beach, WA

5d•Remote

About The Position

Molina Healthcare is hiring a remote RN Care Manager for its Washington State Health Plan, with a preference—but not a requirement—for candidates located in Washington. The role works Pacific Standard Time hours and supports Medicare members through telephonic case management and transition-of-care functions. The description 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 Care Manager supports care management and care coordination activities and collaborates with a multidisciplinary team to coordinate integrated member care across the continuum. The role works to help members progress toward desired outcomes and contributes to quality, cost-effective care. Previous RN care management experience at a managed care organization is highly desired.

Requirements

At least 2 years of experience in health care, preferably in care management or in a medical and/or behavioral health setting, or an equivalent combination of relevant education and experience.
Registered Nurse (RN) with an active, unrestricted license in the state of practice; the posting also specifies compact licensure.
Valid, unrestricted driver’s license, reliable transportation, and adequate auto insurance for job-related travel, 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 approach when working with diverse populations, personalities, and personal situations.
Ability to work independently with minimal supervision and demonstrate self-motivation.
Responsive communication and ability to remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Strong time-management and prioritization skills; ability to handle multiple projects and adapt to change.
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).
Washington state residence is preferred, but not required.

Responsibilities

Complete comprehensive member assessments within regulated timelines and use clinical judgment, changes in health or psychosocial wellness, and assessment triggers to determine potential eligibility for care management.
Develop and implement care coordination plans with members, caregivers, physicians, other appropriate health care professionals, and the member’s support network.
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 (ICT) meetings and informal ICT collaboration.
Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate members during contacts.
Assess barriers to care and coordinate care 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.
Meet local travel requirements when applicable, estimated at 25–40% based on state or contractual requirements.