Behavioral Health Case Manager RN

$49,421 - $107,099/Yr

Molina Healthcare - Florence, SC

Full-time - Mid Level

Florence, SC

Insurance Carriers and Related Activities

About the position

The RN Behavioral Health Case Manager will work in both remote and field settings to support the Medicaid SMI (Severe Mental Illness) population in South Carolina. This role involves telephonic communication and face-to-face meetings with members, participating in interdisciplinary care team meetings, and ensuring that care plans are tailored to the members' health needs. The position requires excellent computer skills and attention to detail to manage multiple systems and maintain accurate documentation. Productivity is crucial in this fast-paced environment, with travel required for member visits.

Responsibilities

• Complete comprehensive assessments of members per regulated timelines to determine eligibility for case management.
• Develop and implement case management plans in collaboration with members, caregivers, and healthcare professionals.
• Conduct face-to-face or home visits as required.
• Perform ongoing monitoring of care plans to evaluate effectiveness and suggest changes as needed.
• Maintain an ongoing member case load for regular outreach and management.
• Promote integration of services for members, including behavioral health care and long-term services.
• Facilitate interdisciplinary care team meetings and informal collaborations.
• Use motivational interviewing techniques to educate and support members during contacts.
• Assess barriers to care and provide coordination and assistance to address concerns.
• Conduct medication reconciliation when needed.

Requirements

• Graduate from an Accredited School of Nursing.
• Active, unrestricted State Registered Nursing (RN) license in good standing.
• 1-3 years of experience in case management, disease management, managed care, or medical/behavioral health settings.
• Valid driver's license with a good driving record.

Nice-to-haves

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

Benefits

• Competitive benefits and compensation package.