Care Manager (RN)

Molina Healthcare • Portland, OR

4d • $26 - $59

About The Position

The Care Manager (RN) provides support for care management and care coordination activities, collaborating 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 strategies for delivering quality, cost-effective care.

The Care Manager completes assessments, develops and monitors care plans, maintains an ongoing member caseload, and coordinates services and resources. The role also facilitates interdisciplinary collaboration, supports members in addressing barriers to care, and may provide consultation to peers. Care Manager RNs may be assigned complex cases and medication regimens and may conduct medication reconciliation as needed.

Requirements

• Previous 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 and 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 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.
• Strong time-management and prioritization skills, with the ability to manage multiple projects and adapt to change.
• Strong 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

• At least 5 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.

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 in collaboration with members, caregivers, physicians, other appropriate health care professionals, and member support networks.
• Conduct telephonic activities 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 provide care 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.

Benefits

• Competitive benefits and compensation package.

What This Job Offers

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