Case Manager

$102,232 - $102,232/Yr

Molina Healthcare - Newport News, VA

Full-time - Mid Level

Newport News, VA

251-500 employees

Insurance Carriers and Related Activities

About the position

As a Case Manager at Molina Healthcare, you will collaborate with members, providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate integrated care delivery for members with high needs, including behavioral health and long-term care. This role requires strong analytical and consultative skills to ensure quality care and support for members, while also managing a caseload and conducting assessments in both remote and field settings.

Responsibilities

• Complete clinical assessments of members per regulated timelines and determine eligibility for case management based on clinical judgment.
• Develop and implement a case management plan in collaboration with the member, caregiver, physician, and other healthcare professionals.
• Conduct telephonic, face-to-face, or home visits as required.
• Perform ongoing monitoring of the care plan to evaluate effectiveness and suggest changes as needed.
• Maintain an ongoing member caseload for regular outreach and management.
• Promote integration of services for members, including behavioral health care and long-term services and supports.
• Facilitate interdisciplinary care team meetings and informal collaboration.
• Use motivational interviewing and clinical guideposts to educate and support members during contacts.
• Assess for barriers to care and provide coordination and assistance to address concerns.
• Collaborate with RN case managers/supervisors as needed.

Requirements

• Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or Master's Degree in social science, psychology, gerontology, public health, social work, or related field.
• 1-3 years of experience in case management, disease management, managed care, or medical/behavioral health settings.
• Active, unrestricted license if required for the job, and a valid driver's license with a good driving record.

Nice-to-haves

• 3-5 years of experience in case management, disease management, managed care, or medical/behavioral health settings.
• Licensed Clinical Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education and Promotion (CHEP), Licensed Professional Counselor (LPC/LPCC), Respiratory Therapist, or Licensed Marriage and Family Therapist (LMFT).

Benefits

• Medical, Dental, and Vision Insurance
• Group & Voluntary Life Insurance
• Flexible Spending Accounts
• 401K and Roth 401K
• Employee Stock Purchase Plan
• Continuing Education Units
• Education Reimbursement
• Paid Time Off
• Volunteer Time Off
• Company Holidays
• Legal Assistance Plan
• Employee Assistance & Well Being Programs
• Employee Perks Platform
• Rideshare Portal