RN Case Manager - California CCS Program - #603974

Molina Healthcare

Date: 11/25/2021 20:00 PM

City: Long Beach, California

Contract type: Full Time

Work schedule: Full Day


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


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


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.

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