Care Management Registered Nurse in Chubbuck, ID
Job Description
JOB SUMMARY
Join our team as a Care Management Registered Nurse, where you will be essential in supporting long-term services and coordinating care for our members with high-need potential. Your role will be vital in ensuring member progress towards desired outcomes and contributing to our strategy of providing quality, cost-effective care.
ESSENTIAL JOB DUTIES
• Conduct comprehensive member assessments within regulated timelines, including required in-person home visits.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement care plans, including waiver service plans, in collaboration with members, caregivers, physicians, and appropriate health care professionals.
• Monitor care plans to evaluate effectiveness, document interventions, and adjust goals as needed.
• Promote the integration of services, including behavioral health care and long-term services and supports (LTSS).
• Assess medical necessity and authorize appropriate waiver services.
• Evaluate covered benefits and provide guidance regarding funding sources.
• Facilitate interdisciplinary care team (ICT) meetings and promote collaboration.
• Utilize motivational interviewing to educate and support members during contacts.
• Identify barriers to care and assist members in resolving psycho/social, financial, and medical challenges.
• Identify critical incidents and develop prevention plans to ensure member health and welfare.
• Consult with peers as needed and manage complex member cases and medication regimens.
• Conduct medication reconciliation as necessary.
• Travel locally approximately 25-40% as required.
REQUIRED QUALIFICATIONS
• At least 2 years of healthcare experience, including 1 year in care management, managed care, or a relevant medical or behavioral health setting.
• 1 year of experience working with individuals with disabilities, chronic conditions, or substance use disorders.
• Active and unrestricted RN license in the state of practice.
• Valid driver's license, reliable transportation, and adequate auto insurance for job-related travel.
• Detail-oriented with proactive work habits.
• Keen knowledge of community resources.
• Ability to work independently and adapt to diverse settings and personalities.
• Strong communication skills and the ability to remain calm under pressure.
• Outstanding time-management and problem-solving abilities.
• Proficient in Microsoft Office Suite and relevant software.
• Experience working with individuals with substance use disorders in some states is preferred.
PREFERRED QUALIFICATIONS
• Certified Case Manager (CCM).
• Experience working with populations receiving waiver services.
If you're an aspiring candidate passionate about coordinating care and making a difference, we encourage you to apply. Molina Healthcare offers a competitive benefits and compensation package. We are an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $26.41 - $51.49 / HOURLY
• Compensation may vary based on geographic location, work experience, education, and skill level.
Join our team as a Care Management Registered Nurse, where you will be essential in supporting long-term services and coordinating care for our members with high-need potential. Your role will be vital in ensuring member progress towards desired outcomes and contributing to our strategy of providing quality, cost-effective care.
ESSENTIAL JOB DUTIES
• Conduct comprehensive member assessments within regulated timelines, including required in-person home visits.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement care plans, including waiver service plans, in collaboration with members, caregivers, physicians, and appropriate health care professionals.
• Monitor care plans to evaluate effectiveness, document interventions, and adjust goals as needed.
• Promote the integration of services, including behavioral health care and long-term services and supports (LTSS).
• Assess medical necessity and authorize appropriate waiver services.
• Evaluate covered benefits and provide guidance regarding funding sources.
• Facilitate interdisciplinary care team (ICT) meetings and promote collaboration.
• Utilize motivational interviewing to educate and support members during contacts.
• Identify barriers to care and assist members in resolving psycho/social, financial, and medical challenges.
• Identify critical incidents and develop prevention plans to ensure member health and welfare.
• Consult with peers as needed and manage complex member cases and medication regimens.
• Conduct medication reconciliation as necessary.
• Travel locally approximately 25-40% as required.
REQUIRED QUALIFICATIONS
• At least 2 years of healthcare experience, including 1 year in care management, managed care, or a relevant medical or behavioral health setting.
• 1 year of experience working with individuals with disabilities, chronic conditions, or substance use disorders.
• Active and unrestricted RN license in the state of practice.
• Valid driver's license, reliable transportation, and adequate auto insurance for job-related travel.
• Detail-oriented with proactive work habits.
• Keen knowledge of community resources.
• Ability to work independently and adapt to diverse settings and personalities.
• Strong communication skills and the ability to remain calm under pressure.
• Outstanding time-management and problem-solving abilities.
• Proficient in Microsoft Office Suite and relevant software.
• Experience working with individuals with substance use disorders in some states is preferred.
PREFERRED QUALIFICATIONS
• Certified Case Manager (CCM).
• Experience working with populations receiving waiver services.
If you're an aspiring candidate passionate about coordinating care and making a difference, we encourage you to apply. Molina Healthcare offers a competitive benefits and compensation package. We are an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $26.41 - $51.49 / HOURLY
• Compensation may vary based on geographic location, work experience, education, and skill level.
Job Details
Medical Speciality
Home HealthGeriatricsPublic health
Employment Type
Full-time
Required License
RN (Registered Nurse)
Work Setting
ClinicOffice
About Molina Healthcare
Molina Healthcare is a leading health care provider dedicated to improving the health and lives of its members. With over 30 years of experience, Molina specializes in delivering high-quality and affordable health care solutions. The company focuses on addressing the unique needs of its members by offering a range of services designed to promote overall well-being and access to essential health care. Molina's commitment to quality and affordability sets it apart in the industry, making it a trusted choice for many seeking comprehensive health care coverage.