RN Care Manager reputed company Adult Care REMOTE based in reputed company

JOB DESCRIPTION Job Summary reputed company Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients reputed company toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. This position will be supporting our reputed company Adult Medical Care Management program. The ideal candidate will bring strong expertise in chronic disease management, with familiarity in evidence-based practices for conditions commonly seen, such as hypertension, diabetes, asthma, COPD, and chronic kidney disease/ESRD. Skilled in closing HEDIS and preventive care gaps through proactive reputed company and coordination with members and providers. Experience integrating medical and behavioral health needs in care planning, along with an understanding clinical guidelines, social determinants of health, and health equity principles is also beneficial. Case management and managed care experience is preferred. Remote position based in reputed company A reputed company RN licensure is required Work schedule Monday - Friday 8:30 AM to 5:00 PM EST. KNOWLEDGE/SKILLS/ABILITIES

• 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 reputed company 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 reputed company 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.

% local travel required.

• RNs provide consultation, recommendations and education as appropriate to non-RN case managers.
• RNs are assigned cases with members who have reputed company medical conditions and medication regimens
• RNs conduct medication reconciliation reputed company needed.

JOB QUALIFICATIONS Required Education Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred. Required Experience 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 reputed company applicable state or locality with reliable transportation. Preferred Education Bachelor's Degree in Nursing Preferred Experience 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $ $61.79 / HOURLY

• Actual compensation may vary from posting based on geographic location, work experience, education and/or reputed company level.

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