Care Manager (RN)- Kentucky

$25.08 - $51.49 / hour

JOB DESCRIPTION Job Summary

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.

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).

Behavioral health background.

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/V

Pay Range: $25.08 - $51.49 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Share this job

Related Jobs

Med-Surg

Full-time

3 days ago

RN-Medical/Surgical, Full-Time, Nights

ScionHealth Logan, WV

Description Step into a meaningful role at Logan Regional Medical Center, a 132-bed facility located in southern West Virginia. Logan Regional is an award-winning, full-service community hospital with a history of innovation, from its one-of-a-kind Rural General Surgery residency program to its collaboration with Marshall Health Network to bring more opportunities for specialty care to the area. Logan Regional has earned the prestigious 'A' grade from The Leapfrog Group, inclusion in Becker’s listing of Great Community Hospitals, Forbes Inaugural Top Hospitals list, and Best-in-State hospital status from Newsweek/Statista. Consider growing your career at Logan Regional, which offers an ideal combination of high standards of care in a small, caring community. $20k Sign-On Bonus! Job Summary The Registered Nurse (RN) – Medical/Surgical provides safe, effective, and compassionate patient care using the nursing process of assessment, planning, intervention, and evaluation in an acute care hospital setting. The RN collaborates with the interdisciplinary team, patients, and families to achieve optimal patient outcomes, ensuring care is delivered in accordance with standards of professional nursing practice, hospital policies, and regulatory requirements. Essential Functions Performs comprehensive assessments and reassessments to determine nursing care needs Develops, implements, and evaluates individualized plans of care Administers medications and treatments in accordance with policy and physician orders Documents assessments, interventions, outcomes, and patient education timely and accurately Provides direct care including ADLs, hygiene, nutrition, and mobility support Monitors patient conditions and communicates significant changes to the care team Collaborates with interdisciplinary team for care coordination, discharge planning, and referrals Provides emotional and psychosocial support to patients and families Ensures patient safety through adherence to infection control and fall prevention protocols Supervises and delegates tasks appropriately to licensed and unlicensed staff Knowledge/Skills/Abilities/Expectations Proficient in clinical assessment, documentation, and patient care planning Knowledge of medical terminology, pharmacology, and nursing best practices Strong interpersonal, communication, and organizational skills Ability to function effectively in high-stress situations with diverse patient populations Familiarity with electronic medical records (EMR) and clinical documentation systems Ability to lift up to 50 lbs and perform extended standing, walking, and physical activity Demonstrates professional integrity, accountability, and a commitment to continuing education Qualifications Education Associate degree in Nursing required Bachelor of Science in Nursing (BSN) preferred License/Certification Current state RN license or compact state equivalent required Basic Life Support (BLS) required per facility policy Advanced Cardiovascular Life Support (ACLS) required per facility policy Crisis Prevention Intervention (CPI) required per facility policy Specialty certification (e.g., RN-BC, CMSRN) preferred Experience Minimum of 6 months of Medical/Surgical nursing experience in an acute care setting preferred Demonstrated critical thinking, decision-making, and effective prioritization in a fast-paced environment.

PCU

Full-time

5 days ago

RN, Stepdown, Full-Time, Nights

ScionHealth Logan, WV

Description Step into a meaningful role at Logan Regional Medical Center , a 132-bed facility located in southern West Virginia. Logan Regional is an award-winning, full-service community hospital with a history of innovation, from its one-of-a-kind Rural General Surgery residency program to its collaboration with Mountain Health Network and Marshall Health to bring more opportunities for specialty care to the area. Logan Regional has earned the prestigious 'A' grade from The Leapfrog Group, inclusion in Becker’s listing of Great Community Hospitals, and Best-in-State hospital status from Newsweek/Statista. Consider growing your career at Logan Regional, which offers an ideal combination of high standards of care in a small, caring community. Job Summary Under the direction of the nurse manager, the registered nurse is responsible for assessing, planning, implementing, and evaluating nursing care for a defined group of patients in the stepdown unit. The RN coordinates care delivery to achieve optimal patient outcomes and supports the patient and family through the care continuum. Essential Functions Collects, records, and analyzes patient conditions and provides care in accordance with patient needs Performs nursing interventions and monitoring, documenting and communicating condition changes to the healthcare team Educates patients and families; promotes physical and emotional well-being Provides discharge planning and patient/family teaching Delegates tasks to licensed and unlicensed personnel in accordance with scope of practice Maintains clinical competence in stepdown nursing practices Collaborates with interdisciplinary team members to ensure high-quality patient outcomes Participates in quality improvement and regulatory compliance efforts Knowledge/Skills/Abilities/Expectations Exhibits critical thinking skills, decisive judgment, and the ability to work with minimal supervision in a high-stress environment Demonstrates effective verbal and written communication and strong interpersonal skills Maintains a professional and cooperative working relationship with patients, families, and the healthcare team Adheres to standards of care, policies, procedures, and ethical practices Works scheduled shifts as required and maintains compliance with orientation and mandatory education Must be able to lift up to 50 pounds Requires standing and walking for extended periods Must perform repetitive tasks and respond quickly to emergency situations Acute care hospital stepdown unit setting Exposure to bloodborne pathogens, infectious diseases, and chemical agents May include variable shifts including nights, weekends, and holidays Qualifications Education Completion of an accredited program for Registered Nursing. Required Bachelor’s degree in Nursing, preferred Licenses/Certifications Current state license as a Registered Nurse Basic Life Support (BLS) Advanced Cardiovascular Life Support (ACLS); other certifications within time frame required by facility policy Experience One (1) year of nursing experience preferred

ICU

Full-time

5 days ago

RN, ICU, Full Time, Nights

ScionHealth Logan, WV

Description Step into a meaningful role at Logan Regional Medical Center , a 132-bed facility located in southern West Virginia. Logan Regional is an award-winning, full-service community hospital with a history of innovation, from its one-of-a-kind Rural General Surgery residency program to its collaboration with Mountain Health Network and Marshall Health to bring more opportunities for specialty care to the area. Logan Regional has earned the prestigious 'A' grade from The Leapfrog Group, inclusion in Becker’s listing of Great Community Hospitals, and Best-in-State hospital status from Newsweek/Statista. Consider growing your career at Logan Regional, which offers an ideal combination of high standards of care in a small, caring community. Job Summary The Registered Nurse (RN) - ICU provides comprehensive nursing care to critically ill patients in the Intensive Care Unit. The RN monitors hemodynamic status, administers medications, performs assessments, and collaborates with the interdisciplinary care team. The RN ensures optimal patient outcomes through adherence to clinical protocols, safety guidelines, and effective communication with patients and families. Essential Functions Provides direct and indirect patient care in a critical care setting, including hemodynamic monitoring and management of critically ill patients Administers medications, monitors for side effects, and responds to adverse events Performs comprehensive assessments, including head-to-toe assessments, pain assessments, and reassessments Develops and implements individualized care plans based on patient condition and response to treatment Collaborates with physicians, respiratory therapists, and other healthcare providers to optimize patient care Educates patients and families on treatment plans, medication regimens, and discharge instructions Participates in emergency response and crisis management, including code blue and rapid response situations Assists in invasive procedures, including central line insertions and arterial line placements Adheres to infection control protocols and maintains a safe environment for patients and staff Documents patient care activities, assessments, and interventions accurately and timely in the electronic medical record (EMR) Knowledge/Skills/Abilities/Expectations Advanced clinical knowledge in critical care nursing and emergency response Strong communication and interpersonal skills Ability to prioritize tasks and manage multiple responsibilities effectively Proficiency in electronic medical records (EMR) and medical equipment operation Demonstrates professionalism, integrity, and a commitment to patient-centered care Ability to lift up to 50 lbs and perform extended periods of standing, walking, and physical activity Qualifications Education Associate Degree in Nursing (ADN) required Bachelor of Science in Nursing (BSN) preferred License/Certification Current RN license in the state of practice or compact state required Basic Life Support (BLS) Certification within timeframe specified by facility policy Advanced Cardiovascular Life Support (ACLS) Certification within timeframe specified by facility policy Pediatric Advanced Life Support (PALS) Certification preferred De-escalation Training required Experience Minimum of six (6) months of experience in an acute care setting preferred

Labor and Delivery

Full-time

1 week ago

RN-Labor & Delivery, Full Time, Nights

ScionHealth Logan, WV

Description At ScionHealth , we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary The Registered Nurse (RN) – Labor & Delivery provides comprehensive nursing care to patients during labor, delivery, and postpartum stages. The RN is responsible for monitoring fetal and maternal well-being, administering medications, assisting with deliveries, and educating patients and families. The RN collaborates with interdisciplinary team members to ensure optimal patient outcomes and quality care in a high-acuity setting. $20,000 Sign-On Bonus Eligible! Essential Functions Provides comprehensive nursing care to laboring patients, including monitoring vital signs and fetal heart tones Assists with labor, delivery, and postpartum care, including Cesarean sections and emergency interventions Administers medications and monitors for side effects and adverse reactions Educates patients and families on postpartum care, breastfeeding, and newborn care Assists with newborn resuscitation and stabilization as required Collaborates with obstetricians, neonatologists, and other members of the healthcare team Documents patient care, assessments, and interventions accurately and in a timely manner Provides emotional support and advocacy for patients and their families Ensures a clean, safe, and organized work environment, adhering to infection control protocols Participates in quality improvement initiatives and staff training programs Knowledge/Skills/Abilities/Expectations Strong clinical skills in obstetric and neonatal care Proficient in fetal monitoring and neonatal resuscitation Excellent communication and interpersonal skills Ability to work effectively in high-stress, emergency situations Proficient in electronic medical records (EMR) systems Demonstrates professionalism, empathy, and patient-centered care Ability to lift up to 50 lbs and perform extended periods of standing, walking, and physical activity Qualifications Education Associate Degree in Nursing (ADN) required Bachelor of Science in Nursing (BSN) preferred Licenses/Certifications Current state RN license or compact state equivalent required Basic Life Support (BLS) required upon hire or within timeframe specified by facility policy Neonatal Resuscitation Program (NRP) required within timeframe specified by facility policy Advanced Cardiovascular Life Support (ACLS) required within timeframe specified by facility policy Intermediate or Advanced Fetal Monitoring required within timeframe specified by facility policy Certification in Inpatient Obstetric Nursing (RNC-OB) preferred Experience Minimum of six (6) months of experience as a Registered Nurse in labor and delivery or postpartum care preferred

Per Diem

5 days ago

RN, Dialysis, PRN, Days

ScionHealth Logan, WV

Description Step into a meaningful role at Logan Regional Medical Cente r, a 132-bed facility located in southern West Virginia. Logan Regional is an award-winning, full-service community hospital with a history of innovation, from its one-of-a-kind Rural General Surgery residency program to its collaboration with Mountain Health Network and Marshall Health to bring more opportunities for specialty care to the area. Logan Regional has earned the prestigious 'A' grade from The Leapfrog Group, inclusion in Becker’s listing of Great Community Hospitals, and Best-in-State hospital status from Newsweek/Statista. Consider growing your career at Logan Regional, which offers an ideal combination of high standards of care in a small, caring community. Job Summary The Dialysis Registered Nurse provides professional nursing care to patients of the Hospital and under the license of the Hospital in need of renal replacement therapy. This position reports directly to the Dialysis Program Manager or Dialysis Supervisor for the respective facility. Essential Functions Plans and provides patient care for the adult and geriatric patients in the hospital in accordance with physician orders and hospital policy and procedures. Provides quality direct patient care and renal replacement therapies independently, in a professional, considerate and respectful manner. Supervises and directs patient care of other teammates in a treatment area that may or may not be licensed. Interacts and communicates with hospital partners in a collaborative, respectful manner; gives pre and post treatment reports through appropriate reporting process to primary registered nurse Documents patient’s physical assessment, vital signs, patients treatment reviews and observations in patient medical records; brings issues to the attention of the physician and primary nurse. Documents, evaluates and implements dialysis orders Analyzes patient assessments, dialysis orders, laboratory results and, discusses issues with the nephrologist. Communicates emergencies, patient life-threatening complications, and related incidents to supervisor, hospital staff, and the patient’s physician Provides initiation and discontinuation of the prescribed renal replacement therapy, including but not limited to formulating a plan per physician orders, verifying safety measures are in place and complied with, administering medications or other appropriate treatments, and documenting all activity appropriately on the hemodialysis flow sheet or hospital EMR Demonstrates the ability to transfer skill set and work in other Hospital settings when required. Attends Hospital orientation, homeroom meetings, and mandatory in-services as required Verifies accurate charges and documentation are submitted in a timely manner Demonstrates the ability to perform and mentor for modalities hemodialysis and PD. Fosters Quality Improvement by participating in Quality Meetings Act as a resource or preceptor for teammates with less experience. Acts as a resource or subject matter expert for other hospital personnel Knowledge/Skills/Abilities/Expectations Knowledge of the Hemodialysis and Peritoneal Dialysis Process Demonstrated ability to lead and oversee the dialysis process performed by Dialysis Technicians. Demonstrated ability to provide treatments in a safe, therapeutic and cost-effective manner Demonstrated ability to assist with providing quality outcomes and tracking of metrics Basic computer skills and proficiency in MS Word and Outlook required Must have good and regular attendance. Approximate percent of time required to travel: 0% Performs other related duties as assigned. Qualifications Education Associate Degree in Nursing or Nursing Diploma program is required. Graduate of an accredited Bachelors of Science in Nursing preferred. Licenses/Certifications Current RN license in the state of practice required Current CPR certification through American Heart Association Experience Two or more years of experience as a registered nurse At least one year of acute or chronic dialysis experience preferred