Care Manager, Health Management (Remote)-Registered ...

JOB DESCRIPTION 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 u2022 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. u2022 Identifies member needs, closes health care gaps, develops action plans and prioritizes goals, and educates members on best practices to manage medical needs. u2022 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. u2022 Provides general member education to assist with self-management goals, disease management or acute conditions, and provide indicated contingency plan. u2022 Assesses for barriers to care, and provides care coordination and assistance to members to address concerns. u2022 Acts as an advocate for members to guide them through the health care system for transition planning and longitudinal care. u2022 Reinforces medication adherence and education; monitors member reactions to medications and treatments. u2022 Engages member, family, and caregivers telephonically to ensure that a well coordinated action plan is established and continually assesses health status. u2022 Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. u2022 Maintains ongoing member caseload for regular outreach and management. u2022 Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. u2022 May facilitate interdisciplinary care team (ICT) meetings and informal ICT collaboration. u2022 Collaborates with registered nurse care managers/leaders as needed or required. Required Qualifications u2022 At least 2 years experience in health care, including at least 1 year of experience in a direct patient care, and/or managed care, care management, or behavioral health setting, or equivalent combination of relevant education and experience. u2022 Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Practical Counselor (LPC), or Registered Dietician (RD). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. u2022 Demonstrated knowledge of community resources. u2022 Proactive and detail-oriented. u2022 Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. u2022 Ability to work independently, with minimal supervision and demonstrate self-motivation. u2022 Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. u2022 Ability to develop and maintain professional relationships with individuals. u2022 Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. u2022 Excellent problem-solving, and critical-thinking skills. u2022 Strong verbal and written communication skills. u2022 Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications u2022 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/V Pay Range: $24 - $56.17 / HOURLY Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Created: 2026-01-19