Remote Care Manager (RN) - MUST LIVE IN TEXAS

Molina Healthcare•Long Beach, TX

2d•Remote

About The Position

Molina Healthcare is hiring six Texas-licensed registered nurses to provide care management telephonically to Medicaid members across Texas. Members may have complex mental health diagnoses, complex health conditions, and comorbidities. Most duties are performed by phone, though occasional in-person meetings may be required. The schedule is Monday through Friday, 8 a.m. to 5 p.m. in the employee’s time zone, and local travel of approximately 25–40% may be required based on state or contractual requirements. Three openings are intended for RNs with at least two years of behavioral health or substance use disorder experience in any setting; the other three are intended for RNs with at least two years of ICU, CCU, or emergency department experience. Preference is given to candidates who have worked as case managers for another managed care organization. Bilingual ability is a plus. The Care Manager supports care management and coordination, collaborating with a multidisciplinary team to coordinate integrated care across the continuum. The role helps members progress toward desired outcomes and contributes to the delivery of quality, cost-effective care.

Requirements

At least two years of health care experience, preferably in care management, or experience in a medical or behavioral health setting, or an equivalent combination of relevant education and experience.
Active, unrestricted Registered Nurse (RN) license in the state of practice; the role requires Texas licensure.
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 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.
Responsive communication and ability to remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Strong time-management and prioritization skills, with the 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.
Solid Microsoft Office Suite experience, especially with Outlook, Excel, Teams, and OneNote.

Nice To Haves

At least two years of behavioral health or substance use disorder experience in any setting for three of the openings.
At least two years of ICU, CCU, or emergency department experience for three of the openings.
Experience working as a case manager for another managed care organization.
Bilingual ability.
Certified Case Manager (CCM).

Responsibilities

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