AltaStaff is a staffing agency currently looking for an RN Care Manager II to work with our Managed Care Client!

**This role is fully remote but candidates residing in Texas are highly preferred**

Pay Rate: $43 - 44/hourly

Shift: Monday - Friday 8am to 5pm

RN License is required!

Summary: Care Managers work with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum. This role will be responsible for reaching out to our members to close HEDIS Gaps, for example connect them to their PCP or document a BP reading in our Clinical software or connect them to resources that will help close their Care Gaps. This is very fast environment, daily high case load volume. Needs to meet turn around of 24 hours admission and post discharge from the hospital.

Responsibilities:

• Completes comprehensive 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 identified in 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.

• 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/home and community to enhance the continuity of care for Molina members.

• 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.

POSITION QUALIFICATIONS

• Must have valid RN Licensure

• Must have 2+ years in case management, disease management, managed care or medical or behavioral health settings.

• 2+ years of clinical and/or managed care experience

• Experience specifically with Transition of Care needs post hospitalization, Annual Wellness check ups

• Ability and willingness to travel within assigned territory.

• PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications.

Work Environment Requirements:

• Must be able to to lift at least 30lbs

• Must be able to stand or sit for prolonged periods (75% of the time)

• Private Secured Internet Connection

• Must confirm work environment is safe and secure for work in handling private and sensitive information.

• Constantly operates a computer and other office equipment

• Constantly works indoors in a secluded safe space

• Must have High-speed internet access 25 MBPS minimum; 50 MBPS minimum preferred

If you've applied and would like to view your application status, please visit: https://altastaff.zenople.com/login/ALTA

AltaStaff is an Equal Employment Opportunity Employer. We provide equal employment opportunities to all qualified applicants for employment without regard to age, race, color, creed, religion, sex, marital status, national origin, ancestry, citizenship, disability, veteran status, sexual orientation, or any other protected status, in accordance with applicable federal, state, and local laws.

INDHP