About the Company:
A Fortune 500 multi-state healthcare organization providing quality healthcare to people receiving government assistance.
Our client arranges for the delivery of healthcare services and offers health information management solutions to nearly five million and families who receive their care through Medicaid, Medicare, and other government-funded programs in fifteen states.
- 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.
- 25- 40% local travel required.
- 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.
- Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.
- 1-3 years in case management, disease management, managed care or medical or behavioral health settings.
- Required License, Certification, Association
- 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.
- Bachelor's Degree in Nursing
- 3-5 years in case management, disease management, managed care or medical or behavioral health settings.
- Certified Case Manager (CCM)
- Employee Stock Purchasing Plans
- Paid Holidays
- 401K Matching
- Medical Benefits
- Vision Benefits
- Dental Benefits
- Life Insurance
- Short-term Disability
- Long-term Disability
- Employee Assistance Program
- Flexible Spending Accounting
- Immediate Accrual of Personal Paid Time Off
- Volunteer Paid Time Off
- Referral Bonus Offered
- Short-term Incentive Program
- Employee Wellness Program
- Discounted Programs with Major Retailers
- Tuition Reimbursement
- iLearn Training Technology