Telephonic Case Manager (RN) - TX ONLY - Disease Management

About the position

The Telephonic Case Manager (RN) position at Molina Healthcare is designed for Texas licensed RNs with experience in case management and disease management. The role involves working with members, providers, and multidisciplinary teams to assess and coordinate care for patients with high needs, ensuring quality and cost-effective healthcare delivery. The position requires strong organizational skills and proficiency in Microsoft Office Suite, particularly Outlook, Excel, Teams, and One Note.

Responsibilities

• Complete comprehensive assessments of members to determine eligibility for case management.
• Develop and implement case management plans in collaboration with members and healthcare professionals.
• Conduct face-to-face or home visits as required.
• Monitor care plans for effectiveness and document interventions and goal achievements.
• Maintain an ongoing member case load for regular outreach and management.
• Promote integration of services including behavioral health care and long-term services.
• Facilitate interdisciplinary care team meetings and informal collaborations.
• Use motivational interviewing to educate and support members during contacts.
• Assess barriers to care and provide coordination and assistance to members.
• Conduct medication reconciliation when needed.

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.