Telephonic Bilingual Spanish Case Manager (RN) PACIFIC HOURS at Molina Healthcare

Remote Full-time
About the position

Molina Healthcare Services (HCS) is seeking a Bilingual Spanish Telephonic RN to join our Marketplace Team, focusing on telephonic Case Management. This position is 100% remote, with a schedule from Monday to Friday, 8 AM to 5 PM PST. Flexibility in scheduling is essential, as the role may require working a couple of evenings each week to better reach our members. Candidates must reside in one of the following states: California, Idaho, Washington, Utah, or Nevada. In this fast-paced role, the RN will be responsible for performing comprehensive assessments of members, determining eligibility for case management based on clinical judgment, and developing and implementing case management plans in collaboration with members, caregivers, and healthcare professionals. The RN will also conduct ongoing monitoring of care plans, facilitate interdisciplinary care team meetings, and utilize motivational interviewing techniques to support and educate members. The ideal candidate will possess excellent computer skills and attention to detail, as multitasking between systems and maintaining accurate contact notes is crucial. Experience with Electronic Medical Records (EMR) and Microsoft Office is required. A home office setup with high-speed internet connectivity is necessary, and candidates must provide their own desk and chair. Local travel of 25-40% is expected for face-to-face visits as required.

Responsibilities
• Complete comprehensive assessments of members per regulated timelines.
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• Determine eligibility for case management based on clinical judgment and health changes.
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• Develop and implement case management plans in collaboration with members and healthcare professionals.
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• Conduct ongoing monitoring of care plans to evaluate effectiveness and suggest changes.
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• Maintain an ongoing member case load for regular outreach and management.
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• Promote integration of services for members, including behavioral health care and long-term services.
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• Facilitate interdisciplinary care team meetings and informal collaboration.
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• Use motivational interviewing to educate and support members during contacts.
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• Assess for barriers to care and provide care coordination and assistance.
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• Conduct medication reconciliation when needed.

Requirements
• Graduate from an Accredited School of Nursing.
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• Active, unrestricted State Registered Nursing (RN) license in good standing.
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• 1-3 years of experience in case management, disease management, managed care, or medical/behavioral health settings.
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• Valid driver's license with a good driving record.

Nice-to-haves
• Bachelor's Degree in Nursing (preferred).
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• 3-5 years of experience in case management, disease management, managed care, or medical/behavioral health settings (preferred).
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• Active, unrestricted Certified Case Manager (CCM) certification (preferred).

Benefits
• Competitive benefits and compensation package.
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• Pay range of $23.76 - $51.49 per hour, based on experience and location.

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