RN Supervisor, Care Management at Molina Healthcare

$59,811 - $129,590/Yr

State of South Carolina - Aiken, SC

Full-time - Mid Level

Remote - Aiken, SC

Executive, Legislative, and Other General Government Support

About the position

Molina Healthcare Services (HCS) is seeking a Registered Nurse (RN) to join our team in South Carolina. This remote position requires a valid RN license in South Carolina and offers the flexibility to work from anywhere within the state. The role involves supervising Case Managers who support our Medicaid program, ensuring that our members receive high-quality care that is both medically appropriate and cost-effective. The ideal candidate will have strong leadership skills and experience managing direct reports, as well as a Bachelor of Science in Nursing (BSN), Master of Science in Nursing (MSN), or Certified Case Manager (CCM) certification, which are strongly preferred. As a hands-on supervisor, you will oversee an integrated Care Management team responsible for case management, community connectors, health management, and transition of care activities. Your primary goal will be to assist Molina Healthcare members in achieving optimal clinical, financial, and quality of life outcomes. This includes facilitating safe and effective transitions from acute or inpatient care to lower levels of care or home settings in a cost-efficient manner. You will provide direction and guidance to your team, ensuring that all activities align with our model of care and meet regulatory requirements. In this role, you will manage staff caseloads, assign cases based on complexity, and oversee the use of our electronic case management documentation system. You will also be responsible for training, coaching, and evaluating team members, promoting multidisciplinary collaboration, and engaging with family and caregivers to enhance continuity of care. Regular audits of case management assessments and care plan development will be part of your responsibilities, as well as monitoring hospital discharge visits to prevent unnecessary readmissions. This position requires flexibility, as you may need to travel to the office for leadership meetings when necessary.

Responsibilities

• Oversee an integrated Care Management team responsible for case management, community connectors, health management, and transition of care activities.
• Provide direction and guidance to the care management team to ensure implementation of activities that align with the model of care and meet regulatory requirements.
• Manage staff caseloads and assign cases appropriately based on complexity and case manager experience.
• Ensure compliance with standard Molina processes and HIPAA in the use of the electronic case management documentation system.
• Arrange training as needed for team members.
• Manage, coach, and evaluate the performance of team members; provide employee development and recognition.
• Assist with the selection, orientation, and mentoring of new staff.
• Promote multidisciplinary collaboration and provider outreach to enhance continuity of care.
• Participate in Interdisciplinary Care Team meetings.
• Work with the Manager to ensure adequate staffing and service levels, maintaining customer satisfaction.
• Audit case management assessments and care plan development for completeness and timeliness according to state requirements.
• Monitor onsite hospital discharge visits and post-discharge visits to assure continuity of care and prevent unnecessary readmissions.

Requirements

• Registered Nurse (RN) license in South Carolina or equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license.
• Bachelor's or master's degree in gerontology, public health, or social work with related case management experience.
• 3 or more years of experience in case management, disease management, managed care, or medical or behavioral health settings.
• Active, unrestricted, and in good standing RN license.

Nice-to-haves

• Bachelor's or master's degree in Nursing.
• More than five years of Case Management experience.
• Experience with Medicaid/Medicare Population with increasing responsibility.
• Certified Case Manager (CCM), Certified Professional in Healthcare Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification.

Benefits

• Competitive benefits and compensation package.
• Flexible working hours.
• Remote work opportunity within South Carolina.