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Case Manager - Transition of Care Coach (RN) - South Carolina

Molina Healthcare North Charleston, South Carolina; Cordesville, South Carolina; Saint George, South Carolina; Cayce, South Carolina; Charleston, South Carolina; Sullivans Island, South Carolina Job ID 2025223
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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

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Success Profile

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.

  • Consultative
  • Patient
  • Analytical
  • Quick-Thinking
  • Compassionate
  • Problem-Solver

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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

Benefits

  • Insurance

    Medical · Dental · Vision
    Group & Voluntary Life Insurance
    Aflac · Pet Health · Identity Theft
    Auto & Home Insurance

  • Savings

    Flexible Spending Accounts
    401K · Roth 401K
    Employee Stock Purchase Plan

  • Career Growth

    Continuing Education Units
    Education Reimbursement

  • Time Off

    Paid Time Off
    Volunteer Time Off
    Company Holidays

  • Additional Perks

    Legal Assistance Plan
    Employee Assistance & Well Being Programs
    Employee Perks Platform
    Rideshare Portal

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Responsibilities

JOB DESCRIPTION

For this position we are seeking a (RN) Registered Nurse who lives in South Carolina and must be licensed for the state of Carolina.  Transition of Care RN will work with Medicaid population assisting with transition from hospital to next level of care. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members and providers on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important.

Home office with internet connectivity of high speed required.

This is a remote position but must be willing to come into local office for Team Meetings and/or Training Sessions.

Schedule: Monday thru Friday 8:00AM to 5:00PM EST. (No Weekends or Holidays)

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.

KNOWLEDGE/SKILLS/ABILITIES

  • Follows member throughout a 30-day program that starts at hospital admission and continues through transitions from the acute setting to other settings, including nursing facility placement and private home, with the goal of reduced readmissions.
  • Ensures safe and appropriate transitions by collaborating with hospital discharge planners, as well as with hospitalists, outpatient providers, facility staff, and family/support network, as needed or at the request of member.
  • Ensures member transitions to a setting with adequate caregiving and functional support, as well as medical and medication oversight as required.
  • Works with participating ancillary providers, public agencies, or other service providers to make sure necessary services and equipment are in place for a safe transition.
  • Conducts face-to-face visits of all members while in the hospital and home visits of high-risk members post-discharge.
  • Coordinates care and reassesses member's needs using the Coleman Care Transitions Model recommended post-discharge timeline.
  • Educates and supports member focusing on seven primary areas (ToC Pillars): medication management, use of personal health record, follow up care, signs and symptoms of worsening condition, nutrition, functional needs and or Home and Community-based Services, and advance directives.
  • 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.
  • Facilitates interdisciplinary care team meetings and informal ICT collaboration.
  • 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 will conduct medication reconciliation when needed.
  • 40-50% local travel required.

JOB QUALIFICATIONS

Required Education

Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.

Required Experience

1-3 years hospital discharge planning or home health.

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 hospital discharge planning or home health.

Preferred License, Certification, Association

Active, unrestricted Transitions of Care Sub-Specialty Certification and/or 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.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time Posting Date: 03/29/2024

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