Job Description

Registered Nurse (RN) Care Coordinator

We are looking for a passionate and dedicated Registered Nurse (RN) with a valid license to provide exceptional care management for our Medicaid/Medicare population. As a Care Coordinator RN, you will be instrumental in conducting assessments, creating personalized care plans, educating members, and connecting them with essential community resources. Your detail-oriented approach and strong computer skills are crucial for managing multiple systems and ensuring accurate communication with both members and providers.

This is a remote role that requires a home office setup with high-speed internet. You will work a schedule of Monday through Friday from 8:00 AM to 5:00 PM EST, with occasional flexibility to extend to 6 PM for 1 to 2 nights a week (no weekends or holidays).

Key Responsibilities:

• Conduct comprehensive assessments to identify members who qualify for care management based on clinical judgment and health changes.
• Collaborate with members, caregivers, and healthcare professionals to develop and implement effective care coordination plans that meet individual needs and goals.
• Engage in telephonic, face-to-face, or home visits to provide personalized support.
• Monitor ongoing care plans for effectiveness, documenting interventions and outcomes accurately.
• Maintain a manageable caseload for regular outreach and management of member progress.
• Facilitate access to integrated services, enhancing continuity of care for members.
• Lead interdisciplinary care team meetings to foster collaboration in member care.
• Utilize motivational interviewing techniques to empower members towards positive health changes.
• Identify and address barriers to care, providing supportive coordination and resources.
• Handle complex member cases, including medication reconciliation as required.
• Ability to travel locally as needed, based on state and contractual requirements (25-40% estimated travel).

Qualifications:

• A minimum of 2 years of healthcare experience, ideally in care management or a medical/behavioral health setting.
• Active and unrestricted RN license in your state of practice.
• Valid driver's license, reliable transportation, and adequate auto insurance for travel requirements.
• Understanding of electronic medical records (EMR) and HIPAA regulations.
• Comprehensive knowledge of community resources available to members.
• Strong proactive approach with attention to detail in all tasks.
• Ability to adapt communication style for diverse populations and individual circumstances.
• Self-motivated, with the ability to work independently with minimal supervision.
• Demonstrates calmness under pressure with quick responsiveness in communication.
• Skilled in establishing and maintaining professional relationships.
• Exceptional time-management and multitasking skills to manage various projects effectively.
• Excellent problem-solving and critical-thinking abilities.
• Strong verbal and written communication skills and proficiency in the Microsoft Office suite.

Preferred Qualifications:

• Certified Case Manager (CCM).

Join us and be a part of a team that is dedicated to providing quality, cost-effective member care. Molina Healthcare offers a competitive benefits and compensation package. We are proud to be an Equal Opportunity Employer (EOE) M/F/D/V.

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