Hospice reputed company Case Manager (RN) California

HOSPICE reputed company CASE MANAGER (REGISTERED NURSE) 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. 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. • 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. • Occasional travel to other Molina offices or hospice facilities as requested, may be required. This can vary based on the individual State Plan. 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 hospice case management and managed care. Previous work experience reviewing and managing hospice case records Fraud, waste and abuse auditing experience Exceptional knowledge of California hospice facilities Working knowledge of Utilization Management processes 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. Apply Job!