JOB DESCRIPTIONnnFor this position we are seeking a (RN) Registered Nurse who lives in VIRGINIA and must be licensed for the state of VIRGINIA.nnCase Manager will work in remote and field setting supporting our 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. Members have required assessments every six months and can also require “trigger assessments” if they have hospitalizations. 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.nnTRAVEL (50% or more) 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 Lynchburg Virginia Area. Mileage will be reimbursed.nnHome office with internet connectivity of high speed required.nnSchedule: Monday thru Friday 8:00AM to 5:00PM. - No weekends are HolidaynnJob SummarynnMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.nnKNOWLEDGE/SKILLS/ABILITIESnnCompletes face-to-face comprehensive assessments of members per regulated timelines.nnFacilitates comprehensive waiver enrollment and disenrollment processes.nnDevelops and implements a case management plan, including a waiver service 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.nnPerforms ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.nnPromotes integration of services for members including behavioral health care and long term services and supports, home and community to enhance the continuity of care for Molina members.nnAssesses for medical necessity and authorize all appropriate waiver services.nnEvaluates covered benefits and advise appropriately regarding funding source.nnConducts face-to-face or home visits as required.nnFacilitates interdisciplinary care team meetings for approval or denial of services and informal ICT collaboration.nnUses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.nnAssesses for barriers to care, provides care coordination and assistance to member to address psycho/social, financial, and medical obstacles concerns.nnIdentifies critical incidents and develops prevention plans to assure member's health and welfare.nnProvides consultation, recommendations and education as appropriate to non-RN case managersnnWorks cases with members who have complex medical conditions and medication regimensnnConducts medication reconciliation when needed.nn50-75% travel required.nnJOB QUALIFICATIONSnnRequired EducationnnGraduate from an Accredited School of NursingnnRequired ExperiencennAt least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports.nn1-3 years in case management, disease management, managed care or medical or behavioral health settings.nnRequired License, Certification, AssociationnnActive, unrestricted State Registered Nursing license (RN) in good standingnnIf field work is required, Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.nnState Specific RequirementsnnVirginia: Must have at least one year of experience working directly with individuals with Substance Use DisordersnnPreferred EducationnnBachelor's Degree in NursingnnPreferred Experiencenn3-5 years in case management, disease management, managed care or medical or behavioral health settings.nn1 year experience working with population who receive waiver services.nnPreferred License, Certification, AssociationnnActive and unrestricted Certified Case Manager (CCM)nnTo all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.nnMolina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.nnPay Range: $27.73 - $54.06 / HOURLYnn*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.