Care Manager (RN) (Hendry County, FL)
About The Position
Provides support for care management and care coordination activities and collaborates with a multidisciplinary team to coordinate integrated member care across the continuum. The role works to ensure members progress toward desired outcomes and contributes to the strategy of providing quality, cost-effective care. The Care Manager completes member assessments, develops and monitors care coordination plans, maintains a member caseload, and coordinates services with members, caregivers, clinicians, and community resources. The role may include complex cases and medication regimens, medication reconciliation, and local travel of an estimated 25–40% based on state or contractual requirements.
Requirements
- At least 2 years of experience in health care, preferably in care management or a medical and/or behavioral health setting, or an equivalent combination of relevant education and experience.
- Active, unrestricted Registered Nurse (RN) license in the state of practice.
- 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.
- Responsiveness in all forms of 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 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
- 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 eligibility for care management.
- Develop and implement care coordination plans with members, caregivers, physicians, other 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 support 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 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.
- Travel locally as required; estimated travel is 25–40% based on state or contractual requirements.
Benefits
- Competitive benefits and compensation package.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
