Case Manager (RN)Molina Healthcare
North Charleston, South CarolinaJob ID 2004886
As a Case Manager, you will work 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.
- Full Time
- Level: Mid-Level
- Travel: Yes
- Glassdoor Reviews and Company Rating
What makes you a successful Case Manager at Molina Healthcare? Check out the traits we're looking for and see if you're the right fit.
I love working at a company that sees our members as people not numbers and allow employees to provide individual care to meet the member’s needs.-Lori K. MS, BSW, CADC, Case Manager
If they feel someone cares about them, they are more likely to care for themselves, and their health, in return. Sometimes we have to be their only friend.-Joanne J., Case Manager
A member’s care is enhanced when their care providers think deeply about their situation and then offer assistance and guidance.-Brent A., Case Manager
Medical · Dental · Vision
Group & Voluntary Life Insurance
Aflac · Pet Health · Identity Theft
Auto & Home Insurance
Flexible Spending Accounts
401K · Roth 401K
Employee Stock Purchase Plan
Continuing Education Units
Paid Time Off
Volunteer Time Off
Legal Assistance Plan
Employee Assistance & Well Being Programs
Employee Perks Platform
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.
• 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.
• 25- 40% local travel required.
• 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.
Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.
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.
Bachelor's Degree in Nursing
3-5 years in case management, disease management, managed care or medical or behavioral health settings.
Preferred License, Certification, Association
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.