RN Care Manager Complex Pediatric Care REMOTE based in New York

Other Jobs To Apply

Job DescriptionJob SummaryThe Care Manager RN provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.This position will be supporting our Complex Pediatric Care Management program. The ideal candidate will bring expertise in pediatric conditions such as asthma, diabetes, and ADHD. Skilled in closing HEDIS and preventive care gaps through proactive outreach and coordination with members and providers. Experience integrating medical and behavioral health needs in care planning, along with an understanding of clinical guidelines, social determinants of health, and health equity principles is also beneficial. Case management and managed care experience is preferred.Remote position based in New YorkA New York RN licensure is requiredWork schedule Monday - Friday 8:30 AM to 5:00 PM EST.Essential Job Duties• Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments.• Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.• Conducts telephonic, face-to-face or home visits as required.• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.• Maintains ongoing member caseload for regular outreach and management.• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.• Facilitates interdisciplinary care team (ICT) 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.• May provide consultation, resources and recommendations to peers as needed.• Care manager RNs may be assigned complex member cases and medication regimens.• Care manager RNs may conduct medication reconciliation as needed.• 25-40% estimated local travel may be required (based upon state/contractual requirements).Required Qualifications• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.• Registered Nurse (RN). License must be active and unrestricted in state of practice.• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.• Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA).• Demonstrated knowledge of community resources.• Ability to operate proactively and demonstrate detail-oriented work.• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.• Ability to work independently, with minimal supervision and self-motivation.• Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations.• Ability to develop and maintain professional relationships.• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.• Excellent problem-solving, and critical-thinking skills.• Strong verbal and written communication skills.• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.Preferred Qualifications• Certified Case Manager (CCM).To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/VPay Range: $26.41 - $61.79 / HOURLY• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Back to blog
Ads

Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...