Care Manager (RN)

Molina Healthcare•Long Beach, CA

7d•Hybrid

About The Position

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 Molina Healthcare’s strategy for quality, cost-effective care. This is a hybrid role with approximately 10% local travel within King County. The position manages a caseload of 30–35 members and requires experience in pediatric, NICU, or private duty nursing care management, as well as prior remote work in a care management or clinical setting. Care Manager RNs may be assigned complex cases and medication regimens and may conduct medication reconciliation as needed. The posting also indicates that 25–40% local travel may be required based on state or contractual requirements.

Requirements

At least 2 years of healthcare experience, preferably in care management, or experience in 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 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.
Responsiveness across communication channels 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 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.
Prior remote work experience in a care management or clinical setting.
Care management experience in Pediatrics, NICU, or Private Duty Nursing.
Ability to manage a caseload of 30–35 members.

Nice To Haves

Certified Case Manager (CCM).

Responsibilities

Complete comprehensive member assessments within regulated timelines and identify potential care management eligibility based on clinical judgment, health or psychosocial changes, and assessment triggers.
Develop and implement care coordination plans with members, caregivers, physicians, other healthcare professionals, and the member’s support network.
Conduct telephonic, face-to-face, or home visits as required.
Monitor care plans, document interventions and goal achievement, evaluate effectiveness, and recommend changes.
Maintain an ongoing member caseload and conduct regular outreach and management.
Promote integration of behavioral health, long-term services and supports (LTSS), and home and community resources.
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 services 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.