Case Manager RN - Medicare Population

$52,166 - $107,099/Yr

Molina Healthcare - Spartanburg, SC

Full-time - Mid Level

Remote - Spartanburg, SC

Insurance Carriers and Related Activities

About the position

The Case Manager RN will support the Medicare Population in South Carolina, focusing on telephonic communication with members to complete assessments, develop care plans, and coordinate care. The role involves participation in interdisciplinary care team meetings and ensuring care plans are tailored to members' health needs. This fast-paced position requires excellent computer skills and attention to detail, as multitasking between systems and accurate documentation are essential.

Responsibilities

• Communicate telephonically with members to complete assessments and care plans.
• Coordinate care and participate in interdisciplinary care team meetings.
• Develop and implement case management plans in collaboration with members and healthcare professionals.
• Conduct ongoing monitoring of care plans to evaluate effectiveness and document interventions.
• 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 to educate and support members during contacts.
• Assess for barriers to care and provide 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 compensation package
• Health insurance
• Dental insurance
• Vision insurance
• 401k plan
• Paid time off
• Flexible scheduling options