(RN) Remote Care Manager - CA License req

Molina Healthcare • Grand Rapids, MI • 3h ago

JOB DESCRIPTION

Job Summary

Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments.

Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.

Conducts telephonic, face-to-face or home visits as required.

Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.

Maintains ongoing member caseload for regular outreach and management.

Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.

Facilitates interdisciplinary care team (ICT) 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.

May provide consultation, resources and recommendations to peers as needed.

Care manager RNs may be assigned complex member cases and medication regimens.

Care manager RNs may conduct medication reconciliation as needed.

Required Qualifications

At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.

Registered Nurse (RN). License must be active and unrestricted in state of practice.

Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.

Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA).

Demonstrated knowledge of community resources.

Ability to operate proactively and demonstrate detail-oriented work.

Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.

Ability to work independently, with minimal supervision and self-motivation.

Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations.

Ability to develop and maintain professional relationships.

Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.

Excellent problem-solving, and critical-thinking skills.

Strong verbal and written communication skills.

Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.

Preferred Qualifications

Certified Case Manager (CCM).

Bilingual.

Home Health experience.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $26.41 - $59.21 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Similar Jobs

Key Account Manager, OEM IT Cooling

Grundfos • Grand Rapids, MI • 5h ago

Management & Administrative

Key Account Manager, OEM IT Cooling Apply Now Start applying with LinkedIn Please wait... Job Description Are you passionate about building strategic customer relationships and driving growth in the industrial OEM and IT...

5h ago

Go to Apply

Associate Project Manager Commercialization

Roskam Foods • Kentwood, MI • 8h ago

Management & Administrative

Position Description and Purpose: Founded in 1923 and headquartered in Grand Rapids, Michigan, Roskam Foods is a leading contract manufacturer that partners with world-renowned food brands, retailers, and food service pr...

8h ago

Go to Apply

Receptionist

CU Answers • Grand Rapids, MI • 11h ago

Management & Administrative

Description We're looking for a proactive, detail-oriented Receptionist to support our management team, front-desk operations, and the Client Services & Education teams. This role is essential to creating a positive...

11h ago

Go to Apply

311 Customer Service Representative

City of Grand Rapids • Grand Rapids, MI • 18h ago

Management & Administrative

Nature of Work The purpose of this job is to receive and respond to customer service needs as part of the 311 Customer Service Center through multiple channels including phone, in-person and email interactions. The 311 C...

18h ago

Go to Apply

Administrative Assistant

Insight Global • Grand Rapids, MI • 19h ago

Management & Administrative

Job Description Calendar management (schedules and manages meetings in complex and matrixed environment) - anticipates needs and proactively manages conflicts in schedules. Travel planning and management. Expense managem...

19h ago

Go to Apply

Senior Manager, Oracle SCM (Order Management, Manufacturing, Costing)

PwC • Grand Rapids, MI • 22h ago

Management & Administrative

Specialty/Competency: Oracle Industry/Sector: Not Applicable Time Type: Full time Travel Requirements: Up to 60% At PwC, our people in business application consulting specialise in consulting services for a variety of bu...

22h ago

Go to Apply

Customer Service Representative

Adecco US, Inc. • Lowell, MI • 1d ago

Management & Administrative

Adecco is currently assisting a local Customer in their search for Customer Service Representative positions in Lowell, MI . This is a great opportunity to further your existing skills as a Customer Service Representativ...

1d ago

Go to Apply

Cyber Manager - ServiceNow

Deloitte • Grand Rapids, MI • 1d ago

Management & Administrative

Cyber Manager - ServiceNow Our Deloitte Cyber team understands the unique challenges and opportunities businesses face in cybersecurity. Join our team to deliver powerful solutions to help our clients navigate the ever-c...

1d ago

Go to Apply

Corporate Account Manager, Utilities Solutions

Siemens • Grand Rapids, MI • 1d ago

Management & Administrative

Job Family: Electrification & Automation Req ID: 505997 Here at Siemens, we take pride in enabling sustainable progress through technology. We do this through empowering customers by combining the real and digital wo...

1d ago

Go to Apply

Warehouse Automation Manager

Deloitte • Grand Rapids, MI • 1d ago

Management & Administrative

Warehouse Automation Manager We are a team of strategic advisors, architects, and implementers who drive business transformations. Our diverse talent energizes clients' business functions and technology to maximize value...

1d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)