Case Manager (RN): California

$63,170 - $123,157/Yr

Molina Healthcare - Los Angeles, CA

posted 2 months ago

Full-time
Los Angeles, CA
Insurance Carriers and Related Activities

About the position

The position involves working with Molina Healthcare Services to assess, facilitate, plan, and coordinate integrated care delivery for members with high need potential. The role focuses on ensuring quality care that is medically appropriate and cost-effective, while promoting continuity of care across various services, including behavioral health and long-term care.

Responsibilities

  • Complete comprehensive assessments of members per regulated timelines to determine eligibility for case management.
  • Develop and implement a case management plan in collaboration with members, caregivers, and healthcare professionals.
  • Conduct face-to-face or home visits as required.
  • Perform ongoing monitoring of care plans to evaluate effectiveness and document interventions.
  • Maintain an ongoing member case load for regular outreach and management.
  • Promote integration of services for members, including behavioral health care and long-term services.
  • Facilitate interdisciplinary care team meetings and informal collaborations.
  • Use motivational interviewing to educate and support members during contacts.
  • Assess for barriers to care and provide coordination and assistance to members.
  • Conduct medication reconciliation when needed.

Requirements

  • Graduate from an Accredited School of Nursing.
  • Active, unrestricted State Registered Nursing (RN) license in good standing.
  • 1-3 years of experience in case management, disease management, managed care, or medical/behavioral health settings.
  • Valid driver's license with a good driving record.

Nice-to-haves

  • Bachelor's Degree in Nursing (preferred).
  • 3-5 years of experience in case management, disease management, managed care, or medical/behavioral health settings (preferred).
  • Active, unrestricted Certified Case Manager (CCM) certification (preferred).

Benefits

  • Competitive benefits and compensation package.
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