Case Manager (RN)

$49,421 - $107,099/Yr

Molina Healthcare

Full-time

Insurance Carriers and Related Activities

About the position

The position involves working with Molina Healthcare Services to assess, facilitate, plan, and coordinate integrated care delivery for members with high need potential. The role focuses on ensuring quality, medically appropriate, and cost-effective care across various settings, including behavioral health and long-term care. The RN will conduct comprehensive assessments, develop case management plans, and monitor care effectiveness while promoting service integration for enhanced continuity of care.

Responsibilities

• Complete comprehensive assessments of members per regulated timelines.
• Determine eligibility for case management based on clinical judgment and health changes.
• Develop and implement case management plans in collaboration with members and healthcare professionals.
• Conduct face-to-face or home visits as required.
• Perform ongoing monitoring of care plans to evaluate effectiveness and suggest changes.
• 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 collaboration.
• Use motivational interviewing to educate and support members during contacts.
• Assess for barriers to care and provide coordination and assistance.

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.