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Case Manager II

Roles & Responsibilities

  • Active Virginia licensure (as applicable: LVN/LPN, LCSW/APSW, CCM, LPC/LPCC, etc.) in good standing and valid driver's license with a clean driving record.
  • 1-3 years of experience in case management, disease management, managed care, or medical or behavioral health settings.
  • Ability to perform clinical assessments, determine eligibility for case management, and develop/implement care plans in collaboration with members and care team.
  • Strong computer skills, attention to detail, and ability to multitask across systems; willingness to travel up to 40% and conduct field visits.

Requirements:

  • Complete clinical assessments of members per regulated timelines and determine eligibility for case management based on clinical judgment and changes in member health or psychosocial needs.
  • Develop and implement a case management plan in collaboration with the member, caregiver, physician, and other appropriate healthcare professionals to address member needs and goals.
  • Conduct telephonic, face-to-face, or home visits as required; perform ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and adjust as needed.
  • Maintain an ongoing member caseload with regular outreach; promote integration of services, coordinate care with interdisciplinary care teams, and travel up to 40% as required.

Job description


Remote in NOVA, TW (VA Beach/Chesapeake/Norfolk), Central

Job Description:

For this position we are seeking a Case Manager who lives in VIRGINIA and must be licensed for the state of VIRGINIA.
Case Manager will work in remote and field setting supporting our SMI (Severe Mental Illness) Medicaid Population with. Case Manager will be required to physically go to member's homes to complete Face to Face assessment. You will participate in interdisciplinary care team meetings for our members and ensure they have care plans based on their concerns/health needs. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important.
TRAVEL in the field to do member visits in the surrounding areas will be required. We are looking for a candidate who will work remotely primarily in the Northern Virginia Area (NOVA). TW (VA Beach/Chesapeake/Norfolk), Central Mileage will be reimbursed.
Home office with internet connectivity of high speed required.
Schedule: Monday thru Friday 8:00AM to 5:00PM. - No weekends are Holidays.


Must Have Skills:
KNOWLEDGE/SKILLS/ABILITIES
• Completes clinical assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers from the assessment.
• Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member case load for regular outreach and management.
• Promotes integration of services for members including behavioral health care and long term services and supports to enhance the continuity of care for Molina members.
• May implement specific Molina wellness programs i.e. asthma and depression disease management.
• Facilitates interdisciplinary care team 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.
• Collaborates with RN case managers/supervisors as needed or required
• Case managers in Behavioral Health and Social Science fields may provide consultation, resources and recommendations to peers as needed
• Local travel of up to 40% may be required, depending on the complexity level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's Central Programs unit.

Required Years of Experience:
1-3 years in case management, disease management, managed care or medical or behavioral health settings.

Required Licensure / Education:
If license required for the job, license must be active, unrestricted and in good standing.
Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation. Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or Master's Degree (preferably in a social science, psychology, gerontology, public health or social work or related, Or Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred. Licensed Clinical Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education and Promotion (CHEP), Licensed Professional Counselor (LPC/LPCC), Respiratory Therapist, or Licensed Marriage and Family Therapist (LMFT).

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