Care Manager (RN)

Molina Healthcare • Long Beach, CA

5d • Remote

About The Position

This 100% remote position is part of a fast-paced, high-volume auto-dialer team and is described as different from a typical care management role. The Care Manager provides support for care management and care coordination activities, collaborating with a multidisciplinary team to coordinate integrated member care across the continuum. The role supports members’ progress toward desired outcomes and contributes to the delivery of quality, cost-effective care.

The position requires a compact license. Pacific or Mountain time zones are preferred. An estimated 25–40% local travel may be required, depending on state or contractual requirements.

Requirements

• At least 2 years of health care experience, preferably in care management or 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; a compact license is required.
• 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 adapt to 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.
• Excellent time-management and prioritization skills; ability to handle multiple projects and adapt to change.
• Excellent problem-solving and critical-thinking skills.
• Strong verbal and written communication skills.
• Proficiency with Microsoft Office or applicable software, and ability to navigate online portals and databases.

Nice To Haves

• Certified Case Manager (CCM).
• Pacific or Mountain time zone.

Responsibilities

• Complete comprehensive member assessments within regulated timelines and use clinical judgment, health or psychosocial changes, 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 to address needs and goals.
• 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 collaboration.
• Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate members during contacts.
• Assess barriers to care and coordinate assistance to address members’ concerns.
• Provide consultation, resources, and recommendations to peers as needed.
• Manage complex member cases and medication regimens when assigned.
• Conduct medication reconciliation as needed.

Benefits

• Competitive benefits and compensation package.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed