RN Case Manager - Northern Virginia

$49,421 - $107,099/Yr

Molina Healthcare - Manassas, VA

Full-time - Mid Level

Manassas, VA

Insurance Carriers and Related Activities

About the position

The position is for a Registered Nurse (RN) Case Manager who will work remotely and in the field, primarily supporting the Medicaid population in Northern Virginia. The role involves conducting assessments, developing care plans, and coordinating care for members with complex medical needs. The RN will also be responsible for member visits, documentation, and ensuring quality care delivery.

Responsibilities

• Complete comprehensive assessments of members per regulated timelines.
• Determine eligibility for case management based on clinical judgment and assessment triggers.
• 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 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.