Job detail

Care Manager, Health Management - LVN/RN

Molina Healthcare

#Behavioral Health #LPN #Multidisciplinary Team #Care Coordination #Population Health #LPC #LCSW #Motivational Interviewing #Medication Adherence

Quick overview

This role provides support for health management activities within care management, collaborating with a multidisciplinary team to coordinate integrated member care across various domains. The manager uses clinical judgment to assess needs, close health gaps, develop action plans, and educate members on managing chronic conditions and adopting healthy behaviors.

Requirements summary

Candidates must have at least two years of healthcare experience, including one year in direct patient care, managed care, care management, or behavioral health. A specific clinical licensure (LVN, LPN, LCSW, LPC, or RD) is required only if mandated by state regulations or business models.

Care CoordinationPopulation HealthMotivational InterviewingMedication AdherenceLong-Term CareBehavioral HealthClinical JudgmentTime-ManagementClinical AssessmentTransition PlanningCare ManagementAction PlansBarrier AssessmentSelf-Management GoalsCondition-Specific Education

Job description

PST candidates preferred.
This 100% remote role is part of our auto-dialer team that is fast paced and high volume.
Not your typical care management role.
Job Summary Provides support for health management activities within the care management/care coordination functions.
Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum, including behavioral health, long-term care, and population health-related education and services for members with high-need potential.
Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties
Based on clinical assessment and member reported health care concerns, uses clinical judgment to provide care management or refer members to a higher level of care.
Identifies member needs, closes health care gaps, develops action plans and prioritizes goals, and educates members on best practices to manage medical needs.
Provides condition-specific education designed to assist members and their families in better understanding specific chronic health conditions, how to manage symptoms to prevent conditions from progressing, and adopting healthy lifestyle behaviors.
Provides general member education to assist with self-management goals, disease management or acute conditions, and provide indicated contingency plan.
Assesses for barriers to care, and provides care coordination and assistance to members to address concerns.
Acts as an advocate for members to guide them through the health care system for transition planning and longitudinal care.
Reinforces medication adherence and education; monitors member reactions to medications and treatments.
Engages member, family, and caregivers telephonically to ensure that a well coordinated action plan is established and continually assesses health status.
Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
Maintains ongoing member caseload for regular outreach and management.
Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.

Care Manager, Health Management - LVN/RN

Quick overview

Requirements summary

Job description

Preferred Qualifications

To all current Molina employees

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