Remote Care Manager (RN) - must reside in south central Illinois
About the position Opportunity for Illinois licensed RN to join Molina as a Remote Case Manager working with our Medicare members in south central Illinois (Marion, Richland, Wabash, White, and Jefferson counties). You will complete assessments telephonically with the member to determine the types of services and resources they are eligible to receive. While preference will be given to applicants who have worked for a managed care organization (MCO) like Molina, we will also consider well-seasoned RNs with a strong clinical background. While this position is mostly telephonic, there are times when you may be asked to make a home visit to a member who is near you. Hours are Monday - Friday, 8 AM - 5 PM CST. 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. Requirements • Graduate from an Accredited School of Nursing. • 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. • 1-3 years in case management, disease management, managed care or medical or behavioral health settings. Nice-to-haves • 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). Benefits • Competitive benefits and compensation package. Apply tot his job