Care Manager (Michigan RN) (must reside in Michigan)

Molina Healthcare•Long Beach, CA

12h

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 Care Manager works to ensure members progress toward desired outcomes and contributes to the delivery of quality, cost-effective care. The role includes assessing member needs, developing and monitoring care plans, coordinating services and resources, and maintaining an ongoing member caseload. Care Manager RNs may be assigned complex cases and medication regimens and may conduct medication reconciliation. Up to 5% local travel may be required based on state or contractual requirements. The candidate must reside in Michigan.

Requirements

At least 2 years of experience in health care, 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 communication and work style 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.
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 or applicable software programs and ability to navigate online portals and databases.
Must reside in Michigan.

Nice To Haves

Certified Case Manager (CCM).
Residence within a 20-mile radius of Saginaw, Michigan.
Medicare case management experience.
Discharge planning experience.
Home health experience.

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 professionals, and member support networks to address needs and goals.
Conduct telephonic, face-to-face, or home visits as required.
Monitor care plans on an ongoing basis, evaluate effectiveness, document interventions and goal achievement, and recommend changes as appropriate.
Maintain an ongoing member caseload and provide 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 coordinate care and assistance to address member concerns.
Provide consultation, resources, and recommendations to peers as needed.
For RN care managers, manage assigned complex member cases and medication regimens as applicable.
Conduct medication reconciliation as needed for RN care managers.
Travel locally up to an estimated 5% when required by state or contractual requirements.