Care Manager, Health Management

Molina Healthcare•Long Beach, CA

10d

About The Position

Provides support for health management activities within care management and care coordination functions. Collaborates with a multidisciplinary team to coordinate integrated member care across the continuum, including behavioral health, long-term care, and population health-related education and services for members with high-need potential. Works to ensure members progress toward desired outcomes and contributes to the strategy of providing quality, cost-effective member care.

Requirements

At least 2 years of health care experience, including at least 1 year in direct patient care, managed care, care management, or a behavioral health setting, or an equivalent combination of relevant education and experience.
One of the following credentials: Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Practical Counselor (LPC), or Registered Dietician (RD). Clinical licensure and/or certification is required only when required by state contract, regulation, business operating model, or state board licensing mandates; any license held must be active and unrestricted in the state of practice.
Demonstrated knowledge of community resources.
Proactive and detail-oriented.
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.
Excellent time-management and prioritization skills, including the ability to manage multiple projects and adapt to change.
Excellent problem-solving and critical-thinking skills.
Strong verbal and written communication skills.
Proficiency with Microsoft Office Suite and applicable software programs.

Nice To Haves

Certified Case Manager (CCM).

Responsibilities

Use clinical assessment, member-reported health concerns, and clinical judgment to provide care management or refer members to a higher level of care.
Identify member needs, close health care gaps, develop action plans, prioritize goals, and educate members on best practices for managing medical needs.
Provide condition-specific education to help members and families understand chronic conditions, manage symptoms, prevent progression, and adopt healthy lifestyle behaviors.
Provide general education for self-management goals, disease management, or acute conditions, including an indicated contingency plan.
Assess barriers to care and provide care coordination and assistance to address member concerns.
Advocate for members as they navigate the health care system, including transition planning and longitudinal care.
Reinforce medication adherence and education, and monitor member reactions to medications and treatments.
Engage members, families, and caregivers by telephone to establish a coordinated action plan and continually assess health status.
Monitor care plans on an ongoing basis, evaluate effectiveness, document interventions and goal achievement, and suggest changes as appropriate.
Maintain an ongoing member caseload for regular outreach and management.
Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate change during member contacts.
Facilitate interdisciplinary care team meetings and informal interdisciplinary collaboration as needed.
Collaborate with registered nurse care managers and leaders as needed or required.