RN Transition of Care - Care Manager (Texas)

Molina Healthcare • San Antonio, TX

114d • $26 - $51

About The Position

For this position we are seeking a (RN) Registered Nurse who must live in Texas and have a current active unrestricted RN license in the state of TX. Case Manager RN will work Hybrid (Telephonic and face to face visits within Hospitals) supporting our TX Medicaid population who have recently been admitted into Hospital. The Case Manager will support our members to ensure successful transition from inpatient to outpatient. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Preferred candidates will have previous case management, managed care, inpatient hospital experience. TRAVEL in the field to do member visits in designated Hospitals El Paso, Hidalgo County, and San Antonio TX (mileage reimbursement). Schedule: Monday thru Friday 8:00AM to 5:00PM CST (No weekends or Holidays).

Requirements

• Graduate from an Accredited School of Nursing.
• Active, unrestricted State Registered Nursing (RN) license in good standing.
• Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
• 1-3 years in case management, disease management, managed care or medical or behavioral health settings.

Nice To Haves

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

Responsibilities

• Completes comprehensive assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified in the assessment.
• Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.
• Conducts face-to-face or home visits as required.
• Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member case load for regular outreach and management.
• Promotes integration of services for members including behavioral health care and long term services and supports/home and community to enhance the continuity of care for Molina members.
• Facilitates interdisciplinary care team meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• RNs provide consultation, recommendations and education as appropriate to non-RN case managers.
• RNs are assigned cases with members who have complex medical conditions and medication regimens.
• RNs conduct medication reconciliation when needed.

Benefits

• Competitive benefits and compensation package.

What This Job Offers

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