RN Case Manager - Medicaid Population - Southwest - VA

Molina Healthcare • Wise, VA

411d • $57,678 - $112,445

About The Position

The Case Manager RN position involves working in both remote and field settings to support the Medicaid population, including pediatric, foster care, maternity, and adult members. The role focuses on conducting assessments, creating care plans, and providing education to members, requiring excellent computer skills and attention to detail. The position is fast-paced, emphasizing productivity and effective communication with members.

Requirements

• Graduate from an Accredited School of Nursing.
• Active, unrestricted State Registered Nursing (RN) license in good standing.
• 1-3 years 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 in case management, disease management, managed care, or medical/behavioral health settings preferred.
• Active, unrestricted Certified Case Manager (CCM) certification preferred.

Responsibilities

• Complete comprehensive assessments of members per regulated timelines.
• Develop and implement a case management plan in collaboration with the member, caregiver, physician, and other healthcare professionals.
• Conduct face-to-face or home visits as required.
• Perform ongoing monitoring of the care plan 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 collaboration.
• Use motivational interviewing to educate and support members during contacts.
• Assess for barriers to care and provide care coordination to address concerns.
• Conduct medication reconciliation when needed.

Benefits

• Competitive benefits and compensation package.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree