Care Manager (RN - ECC) - Duval County, FL

Molina Healthcare•Jacksonville, FL

3d•$26 - $51

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 support members’ progress toward desired outcomes and contribute to quality, cost-effective care. The Care Manager completes member assessments, develops and monitors care coordination plans, maintains a caseload, and coordinates with members, caregivers, physicians, other health care professionals, and support networks. Contacts may be conducted by phone, face-to-face, or through home visits. The role also integrates behavioral health, long-term services and supports, and home and community resources; facilitates interdisciplinary care team collaboration; and uses motivational interviewing to educate and support members. Local travel of an estimated 25–40% 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 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.
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 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; ability to manage multiple projects and adapt to change.
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).

Responsibilities

Complete comprehensive member assessments within regulated timelines and determine potential eligibility for care management based on clinical judgment, health or psychosocial changes, and assessment triggers.
Develop and implement care coordination plans with members, caregivers, physicians, health care professionals, and support networks.
Conduct telephonic, face-to-face, or home visits as required.
Monitor care plans, assess 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 support 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 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.
Travel locally as required; estimated travel is 25–40%, depending on state or contractual requirements.