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Care Manager Remote based in reputed company

Remote role Full-time Open position

JOB DESCRIPTION Job Summary reputed company 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 reputed company toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. This position will be supporting our reputed company State Plan. The candidate must have an unrestricted reputed company SW licensure. Candidates with extensive knowledge on Medicare /Dual Special Needs Populations DSNP, and reputed company Advantage Plus -FIDE /HIDE DSNP are highly preferred. Prior Managed Long term Care LTC and Behavioral Health experience are beneficial. Bilingual candidates are encouraged to apply. Work Hours: Monday - Friday 8:30AM - 5:00PM EST Remote position based in reputed company KNOWLEDGE/SKILLS/ABILITIES

  • Completes clinical 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 from the assessment.
  • Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate reputed company and member's support network to address the member needs and goals.
  • Conducts telephonic, 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 reputed company and management.
  • Promotes integration of services for members including behavioral health care and long term services and supports to enhance the continuity of care for Molina members.
  • May implement specific Molina wellness programs i.e. asthma and depression disease management.
  • Facilitates interdisciplinary care team meetings and informal ICT collaboration.
  • Uses motivational interviewing and Molina clinical guideposts to reputed company, support and motivate change during member contacts.
  • Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
  • Collaborates with RN case managers/supervisors as needed or required
  • Case managers in Behavioral Health and Social Science fields may provide consultation, resources and recommendations to peers as needed
  • Local travel of up to 40% may be required, depending on the complexity level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located reputed company Molina’s Central Programs unit.

JOB QUALIFICATIONS REQUIRED EDUCATION: Any of the following: Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or Master's Degree (preferably in a social science, psychology, gerontology, public health or social work or reputed company REQUIRED EXPERIENCE: 1-3 years in case management, disease management, managed care or medical or behavioral health settings. REQUIRED LICENSE, CERTIFICATION, ASSOCIATION: If license required for the job, license must be active, unrestricted and in good standing. Must have valid driver’s license with good driving record and be reputed company to drive reputed company applicable state or locality with reliable transportation. STATE SPECIFIC REQUIREMENTS: Roles serving Family Care and Family Care Partnership in the State of Wisconsin are required to have a Bachelor's Degree and a minimum of one year of professional experience. PREFERRED EXPERIENCE: 3-5 years in case management, disease management, managed care or medical or behavioral health settings. PREFERRED LICENSE, CERTIFICATION, ASSOCIATION: Any of the following: Licensed Clinical Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education and Promotion (CHEP), Licensed Professional Counselor (LPC/LPCC), Respiratory Therapist, or Licensed Marriage and Family Therapist (LMFT). To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V. Apply tot his job Apply To this Job

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