Remote Telephonic Case Manager RN

$49,421 - $107,099/Yr

Molina Healthcare - Richmond, KY

Full-time

Remote - Richmond, KY

Insurance Carriers and Related Activities

About the position

The Remote Telephonic Case Manager RN position at Molina Healthcare involves managing a caseload of members enrolled in the DSNIP Medicare Advantage program across Ohio, Kentucky, and South Carolina. The role requires the Registered Nurse to conduct comprehensive assessments, develop and implement case management plans, and facilitate care coordination to ensure quality and cost-effective care for members with high needs. This fast-paced remote position emphasizes productivity and excellent computer skills, with a focus on member engagement and support.

Responsibilities

• Manage a caseload of members enrolled in the DSNIP Medicare Advantage program.
• Complete comprehensive assessments of members and determine eligibility for case management.
• Develop and implement case management plans in collaboration with members and healthcare professionals.
• Conduct ongoing monitoring of care plans to evaluate effectiveness and suggest changes as needed.
• Promote integration of services for members, including behavioral health and long-term care.
• Facilitate interdisciplinary care team meetings and collaboration.
• Use motivational interviewing techniques to educate and support members during contacts.
• Assess barriers to care and provide coordination and assistance to members.
• Conduct medication reconciliation when necessary.

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.