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Registered Nurse Case Manager Complex Care Remote in New York
Molina Healthcare • Remote • Posted 15 days ago
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Remote • Full-time • $23.76-$51.49/hr • Mid Level
Job Highlights
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Molina Healthcare Services works with members, providers, and multidisciplinary team members to assess, facilitate, plan, and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. This role supports the Complex Adult Case Management program, requiring a Registered Nurse with previous Case/Care Management and managed care experience, particularly in managing complex/chronic medical conditions and knowledge of community resources for social determinants of health concerns. The position is remote, requiring residence in New York and familiarity with upstate and downstate regions.
Responsibilities
- Completes comprehensive assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified in the assessment.
- Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.
- Conducts face-to-face or home visits as required.
- Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
- Maintains ongoing member case load for regular outreach and management.
- Promotes integration of services for members including behavioral health care and long term services and supports/home and community to enhance the continuity of care for Molina members.
- Facilitates interdisciplinary care team meetings and informal ICT collaboration.
- Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
- Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
- RNs provide consultation, recommendations and education as appropriate to non-RN case managers.
- RNs are assigned cases with members who have complex medical conditions and medication regimens
- RNs conduct medication reconciliation when needed.
Qualifications
Required
- Graduate from an Accredited School of Nursing.
- 1-3 years in case management, disease management, managed care or medical or behavioral health settings.
- Active, unrestricted State Registered Nursing (RN) license in good standing.
- Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
Preferred
- Bachelor's Degree in Nursing
- 3-5 years in case management, disease management, managed care or medical or behavioral health settings.
- Active, unrestricted Certified Case Manager (CCM)
About Molina Healthcare
Molina Healthcare is a Fortune 500 managed care company operating in the United States. They offer Medicaid, Medicare, and Marketplace health plans, focusing on providing affordable, quality healthcare to underserved populations. The company has expanded through acquisitions, such as acquiring Magellan Complete Care to enter the Florida market and enhance their services.
Full Job Description
**JOB DESCRIPTION**
**Job Summary**
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**This position will be supporting our Complex Adult Case Management program . We are seeking a Registered Nurse with previous Case/Care Management and managed care experience. Candidates with experience in managing complex / chronic medical conditions and knowledge of community resources for social determinants of health concerns are highly preferred** **_._** **New York RN licensure is re** **quired.** **_details to be discussed during our interview process._**
**Remote position, must reside in New York and agreeable to work with or have familiarity with upstate and downstate regions** .
**Work schedule Monday - Friday 8:30 AM to 5:00 PM EST.**
**KNOWLEDGE/SKILLS/ABILITIES**
+ Completes comprehensive assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified in the assessment.
+ Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.
+ Conducts face-to-face or home visits as required.
+ Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
+ Maintains ongoing member case load for regular outreach and management.
+ Promotes integration of services for members including behavioral health care and long term services and supports/home and community to enhance the continuity of care for Molina members.
+ Facilitates interdisciplinary care team meetings and informal ICT collaboration.
+ Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
+ Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
+ RNs provide consultation, recommendations and education as appropriate to non-RN case managers.
+ RNs are assigned cases with members who have complex medical conditions and medication regimens
+ RNs conduct medication reconciliation when needed.
**JOB QUALIFICATIONS**
**Required Education**
Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.
**Required Experience**
1-3 years in case management, disease management, managed care or medical or behavioral health settings.
**Required License, Certification, Association**
Active, unrestricted State Registered Nursing (RN) license in good standing.
Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
**Preferred Education**
Bachelor's Degree in Nursing
**Preferred Experience**
3-5 years in case management, disease management, managed care or medical or behavioral health settings.
Preferred License, Certification, Association
Active, unrestricted Certified Case Manager (CCM)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $23.76 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Summary**
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**This position will be supporting our Complex Adult Case Management program . We are seeking a Registered Nurse with previous Case/Care Management and managed care experience. Candidates with experience in managing complex / chronic medical conditions and knowledge of community resources for social determinants of health concerns are highly preferred** **_._** **New York RN licensure is re** **quired.** **_details to be discussed during our interview process._**
**Remote position, must reside in New York and agreeable to work with or have familiarity with upstate and downstate regions** .
**Work schedule Monday - Friday 8:30 AM to 5:00 PM EST.**
**KNOWLEDGE/SKILLS/ABILITIES**
+ Completes comprehensive assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified in the assessment.
+ Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.
+ Conducts face-to-face or home visits as required.
+ Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
+ Maintains ongoing member case load for regular outreach and management.
+ Promotes integration of services for members including behavioral health care and long term services and supports/home and community to enhance the continuity of care for Molina members.
+ Facilitates interdisciplinary care team meetings and informal ICT collaboration.
+ Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
+ Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
+ RNs provide consultation, recommendations and education as appropriate to non-RN case managers.
+ RNs are assigned cases with members who have complex medical conditions and medication regimens
+ RNs conduct medication reconciliation when needed.
**JOB QUALIFICATIONS**
**Required Education**
Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.
**Required Experience**
1-3 years in case management, disease management, managed care or medical or behavioral health settings.
**Required License, Certification, Association**
Active, unrestricted State Registered Nursing (RN) license in good standing.
Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
**Preferred Education**
Bachelor's Degree in Nursing
**Preferred Experience**
3-5 years in case management, disease management, managed care or medical or behavioral health settings.
Preferred License, Certification, Association
Active, unrestricted Certified Case Manager (CCM)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $23.76 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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