Registered Nurse REMOTE Case Manager LTSS REMOTE in New York Job at Molina Healthcare
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.
KNOWLEDGE/SKILLS/ABILITIES
Completes face-to-face comprehensive assessments of members per regulated timelines.
Facilitates comprehensive waiver enrollment and disenrollment processes.
Develops and implements a case management plan, including a waiver service 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.
Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
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.
Assesses for medical necessity and authorize all appropriate waiver services.
Evaluates covered benefits and advise appropriately regarding funding source.
Conducts face-to-face or home visits as required.
Facilitates interdisciplinary care team meetings for approval or denial of services 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 psycho/social, financial, and medical obstacles concerns.
Identifies critical incidents and develops prevention plans to assure member's health and welfare.
Provides consultation, recommendations and education as appropriate to non-RN case managers
Works cases with members who have complex medical conditions and medication regimens
Conducts medication reconciliation when needed.
50-75% travel required.
JOB QUALIFICATIONS
Required Education
Graduate from an Accredited School of Nursing
Required Experience
At least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports.
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 license (RN) in good standing
If field work is required, 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.
1 year experience working with population who receive waiver services.
LTSS experience, with long term service types as in CDPAS/PCS/ADC/LTC
Any managed long term care background with case management
Knowledge with Medicaid members and needs
Able and willing to carry a caseload with members that have service types
Any field/Uniform Assessment experience
Bilingual: Spanish preferred
Preferred License, Certification, Association
Active and 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: $26.41 - $51.49 an hour*
Please Note :
ramirezweb.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, ramirezweb.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.
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
Completes face-to-face comprehensive assessments of members per regulated timelines.
Facilitates comprehensive waiver enrollment and disenrollment processes.
Develops and implements a case management plan, including a waiver service 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.
Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
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.
Assesses for medical necessity and authorize all appropriate waiver services.
Evaluates covered benefits and advise appropriately regarding funding source.
Conducts face-to-face or home visits as required.
Facilitates interdisciplinary care team meetings for approval or denial of services 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 psycho/social, financial, and medical obstacles concerns.
Identifies critical incidents and develops prevention plans to assure member's health and welfare.
Provides consultation, recommendations and education as appropriate to non-RN case managers
Works cases with members who have complex medical conditions and medication regimens
Conducts medication reconciliation when needed.
50-75% travel required.
JOB QUALIFICATIONS
Required Education
Graduate from an Accredited School of Nursing
Required Experience
At least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports.
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 license (RN) in good standing
If field work is required, 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.
1 year experience working with population who receive waiver services.
LTSS experience, with long term service types as in CDPAS/PCS/ADC/LTC
Any managed long term care background with case management
Knowledge with Medicaid members and needs
Able and willing to carry a caseload with members that have service types
Any field/Uniform Assessment experience
Bilingual: Spanish preferred
Preferred License, Certification, Association
Active and 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: $26.41 - $51.49 an hour*
- Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Please Note :
ramirezweb.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, ramirezweb.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.