Company Detail

Job Description

Molina Healthcare is hiring for a Community Connector in Northern Iowa.

This position serves as a member advocate and resource connector, using knowledge of the community and resources to engage and assist members in managing their healthcare needs.

You will collaborate with, and support the Healthcare Services team by providing non-clinical paraprofessional duties, including but not limited to, helping to complete annual paperwork, help direct and connect to resources, getting calls out to complete required screenings, etc.

This important and critical role empowers members by helping them navigate and maximize their health plan benefits.

This role will be a hybrid position where you will be mostly working remotely, however you must be available to see members in the community approximately two days per week. An active Drivers License and reliable vehicle is required.

Highly qualified candidates will have the following:

• Live in Northern Iowa

• Be highly customer centric with great communication skills, both written and verbal.

• Able and willing to meet with/work with members face to face.

• Experience in healthcare, home health, medical assisting, etc. Highly preferred is experience with Medicare, Medicaid, Managed Care,

• Must be familiar with MS Word and Excel. Above average computer skills needed as you will need to be able to navigate different computer systems.

KNOWLEDGE/SKILLS/ABILITIES

• Serves as a community-based member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing their healthcare needs.

• Collaborates with and supports the Healthcare Services team by providing non-clinical paraprofessional duties in the field, to include meeting with members in their homes, nursing homes, shelters, or doctor's offices, etc.

• Empowers members by helping them navigate and maximize their health plan benefits.

• Assistance may include scheduling appointments with providers; arranging transportation for healthcare visits; getting prescriptions filled; and following up with members on missed appointments.

• Assists members in accessing social services such as community-based resources for housing, food, employment, etc.

• Provides outreach to locate and/or provide support for disconnected members with special needs.

• Conducts research with available data to locate members Molina Healthcare has been unable to contact (e.g., reviewing internal databases, contacting member providers or caregivers, or travel to last known address or community resource locations such as homeless shelters, etc.)

• Participates in ongoing or project-based activities that may require extensive member outreach (telephonically and/or face-to-face).

• Guides members to maintain Medicaid eligibility and with other financial resources as appropriate.

• Local travel may be required. Reliable transportation and valid driver's license required.

• #LI-TR1

REQUIRED EDUCATION: HS Diploma/GED

PREFERRED EDUCATION: Associates degree in a health care related field (e.g., nutrition, counseling, social work).

REQUIRED EXPERIENCE: Minimum 1 year experience working with underserved or special needs populations, with varied health, economic and educational circumstances.

PREFERRED EXPERIENCE:

• Bilingual based on community need.

• Familiarity with healthcare systems a plus.

• Knowledge of community-specific culture.

• Experience with or knowledge of health care basics, community resources, social services, and/or health education.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

• Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

• Current Community Health Worker (CHW) Certification preferred (for states other than Ohio and Florida, where it is required).

• Active and unrestricted Medical Assistant Certification

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $15.58 to $30.37 per hour* *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Key Words: Community Connector, Nonclinical Case Manager, Care Manager, Community Engagement, Public Health, Healthcare, Health Care, Managed Care, MCO, Medicaid, Medicare, HEDIS, CAPHS, equity community health advisor, family advocate, advocacy, health educator, liaison, promoter, outreach worker, peer counselor, patient navigator, health interpreter, public health aide, community lead, community advocate, nonprofit, non-profit, social worker, case worker, housing counselor, human service worker, Navigator, Assistor, Connecter, Promotora, Marketing, managed care, MCO, member, market, screening, education, educating, resource

Job Detail

• Company:
  Molina Healthcare

Job Description

Molina Healthcare is hiring for a Community Connector in Northern Iowa.

This position serves as a member advocate and resource connector, using knowledge of the community and resources to engage and assist members in managing their healthcare needs.

You will collaborate with, and support the Healthcare Services team by providing non-clinical paraprofessional duties, including but not limited to, helping to complete annual paperwork, help direct and connect to resources, getting calls out to complete required screenings, etc.

This important and critical role empowers members by helping them navigate and maximize their health plan benefits.

This role will be a hybrid position where you will be mostly working remotely, however you must be available to see members in the community approximately two days per week. An active Drivers License and reliable vehicle is required.

Highly qualified candidates will have the following:

• Live in Northern Iowa

• Be highly customer centric with great communication skills, both written and verbal.

• Able and willing to meet with/work with members face to face.

• Experience in healthcare, home health, medical assisting, etc. Highly preferred is experience with Medicare, Medicaid, Managed Care,

• Must be familiar with MS Word and Excel. Above average computer skills needed as you will need to be able to navigate different computer systems.

KNOWLEDGE/SKILLS/ABILITIES

• Serves as a community-based member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing their healthcare needs.

• Collaborates with and supports the Healthcare Services team by providing non-clinical paraprofessional duties in the field, to include meeting with members in their homes, nursing homes, shelters, or doctor's offices, etc.

• Empowers members by helping them navigate and maximize their health plan benefits.

• Assistance may include scheduling appointments with providers; arranging transportation for healthcare visits; getting prescriptions filled; and following up with members on missed appointments.

• Assists members in accessing social services such as community-based resources for housing, food, employment, etc.

• Provides outreach to locate and/or provide support for disconnected members with special needs.

• Conducts research with available data to locate members Molina Healthcare has been unable to contact (e.g., reviewing internal databases, contacting member providers or caregivers, or travel to last known address or community resource locations such as homeless shelters, etc.)

• Participates in ongoing or project-based activities that may require extensive member outreach (telephonically and/or face-to-face).

• Guides members to maintain Medicaid eligibility and with other financial resources as appropriate.

• Local travel may be required. Reliable transportation and valid driver's license required.

• #LI-TR1

REQUIRED EDUCATION: HS Diploma/GED

PREFERRED EDUCATION: Associates degree in a health care related field (e.g., nutrition, counseling, social work).

REQUIRED EXPERIENCE: Minimum 1 year experience working with underserved or special needs populations, with varied health, economic and educational circumstances.

PREFERRED EXPERIENCE:

• Bilingual based on community need.

• Familiarity with healthcare systems a plus.

• Knowledge of community-specific culture.

• Experience with or knowledge of health care basics, community resources, social services, and/or health education.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

• Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

• Current Community Health Worker (CHW) Certification preferred (for states other than Ohio and Florida, where it is required).

• Active and unrestricted Medical Assistant Certification

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $15.58 to $30.37 per hour* *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Key Words: Community Connector, Nonclinical Case Manager, Care Manager, Community Engagement, Public Health, Healthcare, Health Care, Managed Care, MCO, Medicaid, Medicare, HEDIS, CAPHS, equity community health advisor, family advocate, advocacy, health educator, liaison, promoter, outreach worker, peer counselor, patient navigator, health interpreter, public health aide, community lead, community advocate, nonprofit, non-profit, social worker, case worker, housing counselor, human service worker, Navigator, Assistor, Connecter, Promotora, Marketing, managed care, MCO, member, market, screening, education, educating, resource

Job Detail

• Company:
  Molina Healthcare

Job Description

Molina Healthcare is hiring for a Community Connector in Northern Iowa.

This position serves as a member advocate and resource connector, using knowledge of the community and resources to engage and assist members in managing their healthcare needs.

You will collaborate with, and support the Healthcare Services team by providing non-clinical paraprofessional duties, including but not limited to, helping to complete annual paperwork, help direct and connect to resources, getting calls out to complete required screenings, etc.

This important and critical role empowers members by helping them navigate and maximize their health plan benefits.

This role will be a hybrid position where you will be mostly working remotely, however you must be available to see members in the community approximately two days per week. An active Drivers License and reliable vehicle is required.

Highly qualified candidates will have the following:

• Live in Northern Iowa

• Be highly customer centric with great communication skills, both written and verbal.

• Able and willing to meet with/work with members face to face.

• Experience in healthcare, home health, medical assisting, etc. Highly preferred is experience with Medicare, Medicaid, Managed Care,

• Must be familiar with MS Word and Excel. Above average computer skills needed as you will need to be able to navigate different computer systems.

KNOWLEDGE/SKILLS/ABILITIES

• Serves as a community-based member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing their healthcare needs.

• Collaborates with and supports the Healthcare Services team by providing non-clinical paraprofessional duties in the field, to include meeting with members in their homes, nursing homes, shelters, or doctor's offices, etc.

• Empowers members by helping them navigate and maximize their health plan benefits.

• Assistance may include scheduling appointments with providers; arranging transportation for healthcare visits; getting prescriptions filled; and following up with members on missed appointments.

• Assists members in accessing social services such as community-based resources for housing, food, employment, etc.

• Provides outreach to locate and/or provide support for disconnected members with special needs.

• Conducts research with available data to locate members Molina Healthcare has been unable to contact (e.g., reviewing internal databases, contacting member providers or caregivers, or travel to last known address or community resource locations such as homeless shelters, etc.)

• Participates in ongoing or project-based activities that may require extensive member outreach (telephonically and/or face-to-face).

• Guides members to maintain Medicaid eligibility and with other financial resources as appropriate.

• Local travel may be required. Reliable transportation and valid driver's license required.

• #LI-TR1

REQUIRED EDUCATION: HS Diploma/GED

PREFERRED EDUCATION: Associates degree in a health care related field (e.g., nutrition, counseling, social work).

REQUIRED EXPERIENCE: Minimum 1 year experience working with underserved or special needs populations, with varied health, economic and educational circumstances.

PREFERRED EXPERIENCE:

• Bilingual based on community need.

• Familiarity with healthcare systems a plus.

• Knowledge of community-specific culture.

• Experience with or knowledge of health care basics, community resources, social services, and/or health education.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

• Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

• Current Community Health Worker (CHW) Certification preferred (for states other than Ohio and Florida, where it is required).

• Active and unrestricted Medical Assistant Certification

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $15.58 to $30.37 per hour* *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Key Words: Community Connector, Nonclinical Case Manager, Care Manager, Community Engagement, Public Health, Healthcare, Health Care, Managed Care, MCO, Medicaid, Medicare, HEDIS, CAPHS, equity community health advisor, family advocate, advocacy, health educator, liaison, promoter, outreach worker, peer counselor, patient navigator, health interpreter, public health aide, community lead, community advocate, nonprofit, non-profit, social worker, case worker, housing counselor, human service worker, Navigator, Assistor, Connecter, Promotora, Marketing, managed care, MCO, member, market, screening, education, educating, resource

Job Detail

• Company:
  Molina Healthcare

Job Description

Molina Healthcare is hiring for a Community Connector in Northern Iowa.

This position serves as a member advocate and resource connector, using knowledge of the community and resources to engage and assist members in managing their healthcare needs.

You will collaborate with, and support the Healthcare Services team by providing non-clinical paraprofessional duties, including but not limited to, helping to complete annual paperwork, help direct and connect to resources, getting calls out to complete required screenings, etc.

This important and critical role empowers members by helping them navigate and maximize their health plan benefits.

This role will be a hybrid position where you will be mostly working remotely, however you must be available to see members in the community approximately two days per week. An active Drivers License and reliable vehicle is required.

Highly qualified candidates will have the following:

• Live in Northern Iowa

• Be highly customer centric with great communication skills, both written and verbal.

• Able and willing to meet with/work with members face to face.

• Experience in healthcare, home health, medical assisting, etc. Highly preferred is experience with Medicare, Medicaid, Managed Care,

• Must be familiar with MS Word and Excel. Above average computer skills needed as you will need to be able to navigate different computer systems.

KNOWLEDGE/SKILLS/ABILITIES

• Serves as a community-based member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing their healthcare needs.

• Collaborates with and supports the Healthcare Services team by providing non-clinical paraprofessional duties in the field, to include meeting with members in their homes, nursing homes, shelters, or doctor's offices, etc.

• Empowers members by helping them navigate and maximize their health plan benefits.

• Assistance may include scheduling appointments with providers; arranging transportation for healthcare visits; getting prescriptions filled; and following up with members on missed appointments.

• Assists members in accessing social services such as community-based resources for housing, food, employment, etc.

• Provides outreach to locate and/or provide support for disconnected members with special needs.

• Conducts research with available data to locate members Molina Healthcare has been unable to contact (e.g., reviewing internal databases, contacting member providers or caregivers, or travel to last known address or community resource locations such as homeless shelters, etc.)

• Participates in ongoing or project-based activities that may require extensive member outreach (telephonically and/or face-to-face).

• Guides members to maintain Medicaid eligibility and with other financial resources as appropriate.

• Local travel may be required. Reliable transportation and valid driver's license required.

• #LI-TR1

REQUIRED EDUCATION: HS Diploma/GED

PREFERRED EDUCATION: Associates degree in a health care related field (e.g., nutrition, counseling, social work).

REQUIRED EXPERIENCE: Minimum 1 year experience working with underserved or special needs populations, with varied health, economic and educational circumstances.

PREFERRED EXPERIENCE:

• Bilingual based on community need.

• Familiarity with healthcare systems a plus.

• Knowledge of community-specific culture.

• Experience with or knowledge of health care basics, community resources, social services, and/or health education.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

• Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

• Current Community Health Worker (CHW) Certification preferred (for states other than Ohio and Florida, where it is required).

• Active and unrestricted Medical Assistant Certification

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $15.58 to $30.37 per hour* *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Key Words: Community Connector, Nonclinical Case Manager, Care Manager, Community Engagement, Public Health, Healthcare, Health Care, Managed Care, MCO, Medicaid, Medicare, HEDIS, CAPHS, equity community health advisor, family advocate, advocacy, health educator, liaison, promoter, outreach worker, peer counselor, patient navigator, health interpreter, public health aide, community lead, community advocate, nonprofit, non-profit, social worker, case worker, housing counselor, human service worker, Navigator, Assistor, Connecter, Promotora, Marketing, managed care, MCO, member, market, screening, education, educating, resource

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

Molina 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.

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.

JOB QUALIFICATIONS

REQUIRED EDUCATION:

Any of the following:

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

REQUIRED EXPERIENCE:

1-3 years in case management, disease management, managed care or medical or behavioral health settings.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

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.

PREFERRED EXPERIENCE:

3-5 years in case management, disease management, managed care or medical or behavioral health settings.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

Any of the following:

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).

Pay Range: $24.00 - $46.81/hr

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

Molina 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.

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.

JOB QUALIFICATIONS

REQUIRED EDUCATION:

Any of the following:

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

REQUIRED EXPERIENCE:

1-3 years in case management, disease management, managed care or medical or behavioral health settings.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

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.

PREFERRED EXPERIENCE:

3-5 years in case management, disease management, managed care or medical or behavioral health settings.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

Any of the following:

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).

Pay Range: $24.00 - $46.81/hr

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

Molina 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.

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.

JOB QUALIFICATIONS

REQUIRED EDUCATION:

Any of the following:

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

REQUIRED EXPERIENCE:

1-3 years in case management, disease management, managed care or medical or behavioral health settings.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

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.

PREFERRED EXPERIENCE:

3-5 years in case management, disease management, managed care or medical or behavioral health settings.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

Any of the following:

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).

Pay Range: $24.00 - $46.81/hr

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

The Specialist, Member Health & Safety monitors adherence to best practice standards in areas of member health and safety, risk assessment and mitigation, and Critical Incident reporting. This includes reviewing and monitoring of Critical Incidents and adherence to related state contractual obligations regarding Immediately Reportable incidents. Responsible for educating, advising, and consulting staff to reduce or prevent member health and safety related risk.

Job Duties

• Review, monitor, and provide recommendations for Critical Incidents. Monitors compliance with related best practice and quality standards.

• Complete notifications for Immediately Reportable incidents to DHS in compliance with contract requirements; provide regular updates to and serve as primary contact for DHS until incident is resolved.

• Complete member chart reviews, when indicated, for member health and safety concerns and associated interventions. Compile and provide findings to appropriate entities as indicated. Provide timely notification to leadership when additional review is needed.

• Provide mentoring and consultation staff as related to member health and safety; provide monitoring and oversight of member releases from correctional facilities and treatment centers; and provide consultation on member specific cases related to risk assessment and mitigation.

• Assist with the development and maintenance of resources in the area of member health and safety to include domestic violence, law enforcement involvement, abuse, neglect, and self-neglect.

• Attends workgroups and meetings with external organization representatives. Maintaining a continuing working relationship with external organizations and their representatives.

• Attends regular team meetings and collaborates with peers and other departments on projects and initiatives.

• Assists in developing policies and procedures to integrate best practices and inform staff of expected standards of practice as it relates to the Incident Management System, member health and safety, and risk mitigation. Monitor assigned compliance with best practice standards.

• Other duties as assigned.

• This position requires travel 10%-20% of the time.

Job Qualifications

Required Education:

• Bachelor's Degree in Social Work, Health & Human Service or related field or Associate Degree in Nursing.

Required Experience:

• Three or more years of experience in long-term managed care.

Required Licensure or Certification:

A valid State Driver's License

Required Knowledge, Skills, and Abilities:

• The ability to be detail-oriented and solve problems in a fast-faced environment.

• The ability to prioritize Critical Incidents and manage daily deadlines.

• Strong organizational and follow up skills

• Strong investigative skills.

• Strong written and verbal communication skills

Preferred Qualifications:

• Previous care management experience working with persons in the MCO's target population (adults with disabilities and frail elders) in social service care management or related social service experience.

• Understanding of Electronic Medical Records and Health Insurance Privacy and Portability Act (HIPPA).

Travel Requirements:

Driving: 20%

Pay Range: $21.82 - $42.55/hr

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

Molina 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.

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.

JOB QUALIFICATIONS

REQUIRED EDUCATION:

Any of the following:

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

REQUIRED EXPERIENCE:

1-3 years in case management, disease management, managed care or medical or behavioral health settings.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

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.

STATE SPECIFIC REQUIREMENTS:

Roles serving Family Care and Family Care Partnership in the State of Wisconsin are required to have a Bachelor's Degree and a minimum of one year of professional experience.

PREFERRED EXPERIENCE:

3-5 years in case management, disease management, managed care or medical or behavioral health settings.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

Any of the following:

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).

Pay Range: $24.00 - $46.81/hr

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you'll want to keep reading about this rewarding work opportunity!

We are currently looking for a Registered Nurse licensed in Wisconsin to become our next IRIS Self-Directed Personal Care (SDPC) RN. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. People in the IRIS program who need personal care services have the choice to enroll in the IRIS Self-Directed Personal Care (IRIS SPDC) option. You can learn more about IRIS SDPC on the Wisconsin Department of Health Services website here (https://dhs.wisconsin.gov/iris/sdpc.htm) , and learn about the IRIS program here (https://dhs.wisconsin.gov/iris/index.htm) . While this role is home-based, you will have regularly scheduled visits with people in their homes and communities.

As an IRIS SDPC RN, you'll provide oversight and guidance to the people enrolled in the IRIS SDPC option. You'll also build relationships with the people you partner with and ensure that they're getting the most out of the IRIS Self-Directed Personal Care option through assessment, oversight, training and education.

IRIS SDPC RNs are responsible for administering the Wisconsin Personal Care Screening Tool; creating person-centered plans of care; providing personal care oversight to a group of people in IRIS, providing education and training for IRIS participants and care providers, and conducting the required documentation and follow-up. As an IRIS SDPC RN, you'll play an important role in helping people of various backgrounds and abilities live their lives the way they choose.

Knowledge/Skills/Abilities

• Provides personal care assessments and oversight to the My Cares Groups by administering the Wisconsin Personal Care Screening Tool and addendums as required.

• Documents assessment as required by individual tool and Department of Health Services policies, and by completing oversight visits and calls as required.

• Oversees a My Cares Groups of participants, develops individual plans of care, ensures physician orders for care are obtained and reviews and revises plan of care as needed

• Submits for Prior Authorization for personal care services.

• Complies with all Department of Health Services policies and SDPC Guidelines, procedures, and practices along with documentation and program regulations.

• Provides personal care training to participants or care providers as requested and provides educational materials as needed.

• Completes collateral contacts with IRIS Consultants and Long-Term Care Functional Screeners and physicians to ensure care needs are met.

• Completes other duties as assigned.

Job Qualifications

REQUIRED EDUCATION:

Associates Degree in Nursing

REQUIRED EXPERIENCE:

• Minimum 2 years of experience in nursing with at least one year of home health serving individuals with developmental disabilities, physical disabilities, or the elderly.

• Demonstrated computer and software skills required, proficiency with Microsoft Office Suite and database operation/maintenance skills and data entry experience.

• Excellent written and verbal communication skills required and the ability to adapt communication styles to fit situation.

• Strong teaching and mentoring skills.

• Strong analytical and problem-solving skills.

• Good organizational and time management skills with ability to manage tasks independently.

• Flexibility in the work environment and willingness and ability to adapt to changing organizational needs.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

Current unrestricted license in the state of Wisconsin as a Registered Nurse.

Valid Driver's License

PREFERRED EDUCATION:

Bachelor's Degree in Nursing

PREFERRED EXPERIENCE:

Experience providing care through the Wisconsin Medicaid Personal Care Program or one year of home care experience

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $26.41/hr - $51.49/hr*

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

#PJHS

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Molina's Quality Improvement Abstraction team functions to conduct data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The abstraction team will meet chart abstraction productivity standards as well as minimum over read standards.

Job Duties

• Coordinates the HEDIS medical record review which includes ongoing review of records submitted by providers and the annual HEDIS medical record review.

• Participates in meetings with vendors for the medical record collection process.

• As needed, may collects medical records and reports from provider offices, loads data into the HEDIS application, and compares the documentation in the medical record to specifications to determine if preventive and diagnostic services have been correctly performed.

• Participates in scheduled meetings with the National Over read team, National Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results.

Job Qualifications

REQUIRED EDUCATION:

High School Diploma or equivalency

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

• 3 years experience in healthcare

• Basic knowledge and understanding of HEDIS projects

PREFERRED EDUCATION:

Bachelor's Degree

PREFERRED EXPERIENCE:

• At least one year of medical record abstraction experience or 3-5 years experience with HEDIS audits (including but not limited to chart collection, project management, etc.)

• 1 year managed care experience.

• Advanced knowledge of HEDIS and NCQA

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

Active RN license for the State(s) of employment

STATE SPECIFIC REQUIREMENTS:

PHYSICAL DEMANDS:

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

Pay Range: $19.84 - $38.69

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

This position will offer remote work flexibility, but the selected candidate must reside in the state of Michigan.

Job Summary

Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/program management.

Job Duties

• Active collaborator with people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion.

• Plans and directs schedules as well as project budgets.

• Monitors the project from inception through delivery.

• May engage and oversee the work of external vendors.

• Focuses on process improvement, organizational change management, program management and other processes relative to the business.

• Leads and manages team in planning and executing business programs.

• Serves as the subject matter expert in the functional area and leads programs to meet critical needs.

• Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements. Delivers the appropriate artifacts as needed.

• Works with operational leaders within the business to provide recommendations on opportunities for process improvements.

• Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.

• Generate and distribute standard reports on schedule

JOB QUALIFICATIONS

REQUIRED EDUCATION :

Bachelor's Degree or equivalent combination of education and experience.

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :

• 3-5 years of Program and/or Project management experience.

• Operational Process Improvement experience.

• Healthcare experience.

• Experience with Microsoft Project and Visio.

• Excellent presentation and communication skills.

• Experience partnering with different levels of leadership across the organization.

PREFERRED EDUCATION :

Graduate Degree or equivalent combination of education and experience.

PREFERRED EXPERIENCE :

- 5-7 years of Program and/or Project management experience.

- Managed Care experience.

- Experience working in a cross functional highly matrixed organization.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION :

- PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification and/or comparable coursework desired.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $66,456 - $129,590 a year*

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

Molina 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 members 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.

Job Duties

• Assist with housing search and placement along with leveraging supportive services that will assist members at risk of homelessness or discharged from institutions and state centers with maintaining permanent housing and promoting self-sufficiency, including integration into the community. May work to identify other appropriate community residential options for members

• Ensures proper residential authorizations are in place if applicable

• Understand specific needs of the member needing resources, identify available options that are the most cost-effective, most integrated, and meet the outcomes of the members

• Assists with advocacy efforts related to broad-based solutions to help reduce barriers for members to access affordable housing.

• Provides a variety of office and field activities to manage and monitor a rapid re-housing/ transition-in-place program for members.

• Conducts intake interviews and assesses housing barriers of members experiencing homelessness to determine the member's housing and service needs, goals, and eligibility.

• Assists members with development of a strength-based, solution-focused individualized goal and action plan that promotes permanent housing and self-sufficiency.

• Develops an effective, timely referral network for the member to help ensure ongoing direction and support as needed (e.g., community agencies for assistance with budget counseling and education).

• Provides a resource for mediation and advocacy with landlords on the member's behalf to develop a workable plan to obtain and/or maintain housing.

• Participates in housing collaborative and other housing outreach events with the purpose of expanding resource base.

• Creates and maintains consistent communication channels, both verbal and written, between involved parties (e.g., tenant, landlord, referral source, collaborating agencies and public housing authorities).

• Participates in the interdisciplinary care team (ICT) of members needing supportive housing services.

• Provides information and referral assistance regarding available support from appropriate social service agencies and/or community programs by maintaining a housing resource guide.

• Conducts proactive follow-up home visits to ensure stability and further progress towards member self-sufficiency, which may include support, advocacy, reducing isolation, listening, problem solving, and identification of resources to assist with reintegration of member into the community.

• Maintains accurate daily log records, monthly outcome reports, and files for each client. Collects and reports program data as required.

• 5 - 25% local travel required.

JOB QUALIFICATIONS

REQUIRED EDUCATION :

Bachelor's Degree (or equivalent combination of education and relevant experience in lieu of degree)

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :

• Minimum 2 years' experience working with underserved or special needs populations, with varied health, economic and educational circumstances.

• Experience with affordable housing and/or related community resources and social services.

• Knowledge of applicable state and federal guidelines/regulations (e.g., the Fair Housing Act and the rights of people with disabilities under Section 504 of the Rehabilitation Act of 1973).

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION :

Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

PREFERRED EDUCATION :

Bachelor's Degree in a human services or healthcare-related field.

PREFERRED EXPERIENCE :

• Bilingual based on community need.

• Familiarity with healthcare systems/processes, NCQA, and Interqual a plus.

• Knowledge of community-specific culture.

• Experience working with persons who have severe and persistent mental illness, behaviors, and/or AODA issues

• Experience developing care/case management plans.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION :

• Current Community Health Worker (CHW) Certification preferred (mandated in Ohio).

• Medical Assistant Certification

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you!

We're currently looking for someone with a social services or human services background to join our team. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS Program and the TMG IRIS Consultant Agency. While your office will be home-based, you will have regularly scheduled visits with IRIS participants in their home and community.

As an IRIS Consultant (IC), you will build relationships with the people you partner with and help them navigate and get the most out of the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. You can learn more about the IRIS program on the Wisconsin Department of Health Services website here (https://dhs.wisconsin.gov/iris/index.htm) . Together, you will identify the long-term care goals of the people enrolled in IRIS, and find creative ways to achieve those goals.

ICs play an important role in helping people of various backgrounds and abilities live the lives that they choose. In fact, people constantly tell us how supportive our ICs are and what a positive impact our ICs have had on their lives! Successful candidates for this position will be compassionate, genuine, resourceful partners with an eye for high quality work, and who are excited to work side-by side with people enrolled in IRIS.

As an IC, you will connect people to the resources available in their community. You will also help them develop customized IRIS plans for achieving their goals related to employment, housing, health, safety, community membership, transportation, and lasting relationships. While you will have a routine for the work that you do, no two days are alike!

TMG wants to find the best possible candidates, so we created this Realistic Job Preview to provide you with an inside look at the position and our organization. Find out more about the IRIS Consultant position by clicking on the link (https://www.youtube.com/watch?v=2vCojx1dK3I) and then reviewing the job posting below.

TMG is committed to maintaining a diverse and inclusive workforce and prioritizes helping staff have a good work/life balance. Even though the position is remote, you'll have lots of support from your TMG team and coworkers across the organization. If this sounds like the job for you, apply today!

KNOWLEDGE/SKILLS/ABILITIES

• Required to meet in person with the IRIS participant a minimum of four times per year, with one required annual visit in the home of the participant. Because IRIS is a self-directed program, it is important for ICs to be available upon the request of the participant.

• Responsible for providing program orientation to new participants. During this time, participants will learn their rights and responsibilities as someone enrolled in the IRIS program, including verifying legal documents, completing employee paperwork and the responsible use of public dollars.

• Explore a broad view of the participant's life, including goals, important relationships, connections with the local community, interest in employment, awareness of the Self-Directed Personal Care option, and back-up support plans.

• Assist participants in identifying personal outcomes and ensure those outcomes are being met on an ongoing basis, all while staying within the participant's IRIS budget and within the requirements of the IRIS program determined by the Department of Health Services (DHS).

• Responsible for documenting all orientation and planning activities within the IRIS data system (WISITs) within 48 business hours of the visit with the participant.

• Research community resources and natural supports that will fit the individual outcomes for each participant and share that information with them as it becomes available.

• Responsible for documenting progress and changes as needed within the plan and the data system anytime a modification is requested by a participant.

• Budget Amendment or One-Time Expense paperwork may be required depending upon factors associated with the participant and their individual IRIS budget.

• Educate participants on how to read and interpret their monthly budget reports to ensure that participants operate within their budget. Being a liaison between the Fiscal Employer Agency and the IRIS Consultant Agency is also a large part of the position, which includes assisting participants with provider billing, seeking support brokers, tracking receipts, ensuring their workers are paid and mitigating areas of potential risk or conflicts of interest.

• Responsible to develop engaged and trusting relationships with participants and communicate program changes and compliance effectively.

• Responsible to maintain confidentiality and HIPPA compliance.

• Work collaboratively with other IRIS Consultant Agency staff in order to ensure a successful implementation of participants' plans.

• Attend in-person monthly team meetings with other ICs and their supervisor. In addition, weekly IC and IRIS Consultant Supervisor phone check-ins may occur, along with other duties as assigned.

JOB QUALIFICATIONS

Required Education

Bachelor's degree in a social work, psychology, human services, counseling, nursing, special education, or a closely related field (or four years of commensurate experience if no degree).

Required Experience

• 1+ year of direct experience related to the delivery of social services to the target groups (individuals with intellectual or physical disabilities and older adults).

• Ability to work independently, with minimal supervision and be self-motivated.

• Knowledge of Long-Term Care programs and familiarity with principles of self-determination.

• Excellent problem-solving skills, critical thinking skills and strong basic math skills.

• Excellent time management and prioritization skills to focus on multiple projects simultaneously and adapt to change.

• Ability to develop and maintain professional relationships and work through situations without taking it personally.

• Comfortable working within a variety of settings and adjust style as needed; to work with a diverse population, various personalities, and personal situations.

• Resourceful and have knowledge of community resources while being proactive and detail oriented.

• Ability to use a variety of technology including but not limited to, Outlook, Skype, Teams, PowerPoint, Excel, Word, online portals and databases.

Required License, Certification, Association

Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $18.04/hr - $35.17/hr*

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, community, and nursing facility settings. Provides needed care in the environment that patients feel most comfortable and are most receptive including home, nursing facilities, and -pop up- clinic.

The Nurse Practitioner will be required to work primarily in non-clinical settings and provide medical care to all levels of patients. Some programs may focus on specific populations (e.g., adult and geriatric, pediatric, women's health).

Perform comprehensive medical assessments, order appropriate tests/procedures for diagnostic purposes, formulate treatment plans, obtain specialists' consultations as needed, and do appropriate documentations as required.

Job Duties

• Provide general medical care and care coordination to various and/or specific patient levels - adults, women's health, pediatric, and geriatric.

• Perform comprehensive evaluations including history and physical exams for gaps in care and preventative assessments

• Address both chronic and acute primary care complaints, and able to ascertain medical urgency

• Establish and document reasonable medical diagnoses

• Seek specialty consultation as appropriate

• Order/perform pertinent diagnostic laboratory and radiology testing for the medical diagnosis or presenting symptom; able to work within an environment of limited resources and therefore uses diagnostic tests judiciously and appropriately

• Responsible for knowing when a patient's needs are beyond their scope of knowledge and when physician oversight is needed.

• Create and implements a medical plan of care

• Schedule patient appointments for telehealth or in-person visits when appropriate

• Provide post discharge coordination to reduce hospital readmission rates and emergency room utilization

• Perform face-to-face in-person visits in a variety of settings including home, skilled nursing facilities, and public locations.

• Additionally, may perform face-to-face synchronous video communications using Telehealth platform based on business need, leadership direction, and state regulations

• Order bulk laboratory orders to target specific populations of member.

• Perform alternating on-call coverage to triage any urgent lab results and pharmacy inquiries and develop appropriate plan of care

• Participate in community-based -Pop Up Clinics- as way of building relationship with community while addressing gaps in health care

• Drive up to 120 miles a day on a regular basis to a variety of locations within the assigned region. There may be drives beyond 120 miles as part of Extended Mileage Special Project days.

• Obtain and maintain cross state license in other states besides home state based on business need.

• Collaborate with fellow nurse practitioners to develop best practices to perform work duties efficiently and effectively

• Actively participate in regional meetings

• Prescribe medications and perform procedures as appropriate

• Perform timely documentation in medical records in an electronic medical record computer system

• On occasion, may be required to walk flights of stairs while carrying up to 50 lbs. of equipment

JOB QUALIFICATIONS

REQUIRED EDUCATION:

Master's degree in family health from accredited nursing program

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

Advanced computer skills. Proficient with Word, Excel, and Electronic Medical Record.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

• An active and unrestricted national certification from one of the following organizations: American Academy of Nurse Practitioners; American Nurses Credentialing Center

• Current state-issued license to practice as a Family Nurse Practitioner

• Current Basic Life Support for Healthcare Professional certification

• Current unrestricted driver's license

PREFERRED EDUCATION:

PREFERRED EXPERIENCE:

• 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a home health, community health, or public health setting

• Previous experience in home health as a licensed clinician, especially in management of chronic conditions

• Experience with underserved populations facing socioeconomic barriers to health care

• Fluency in a language in addition to English is plus

• Immunization and point of care testing skills

Pay Range: $80k - $156K*

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

#PJHS

#LI-BEMORE

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you'll want to keep reading about this rewarding work opportunity!

We are currently looking for a Registered Nurse licensed in Wisconsin to become our next IRIS Self-Directed Personal Care (SDPC) RN. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. People in the IRIS program who need personal care services have the choice to enroll in the IRIS Self-Directed Personal Care (IRIS SPDC) option. You can learn more about IRIS SDPC on the Wisconsin Department of Health Services website here (https://dhs.wisconsin.gov/iris/sdpc.htm) , and learn about the IRIS program here (https://dhs.wisconsin.gov/iris/index.htm) . While this role is home-based, you will have regularly scheduled visits with people in their homes and communities.

As an IRIS SDPC RN, you'll provide oversight and guidance to the people enrolled in the IRIS SDPC option. You'll also build relationships with the people you partner with and ensure that they're getting the most out of the IRIS Self-Directed Personal Care option through assessment, oversight, training and education.

IRIS SDPC RNs are responsible for administering the Wisconsin Personal Care Screening Tool; creating person-centered plans of care; providing personal care oversight to a group of people in IRIS, providing education and training for IRIS participants and care providers, and conducting the required documentation and follow-up. As an IRIS SDPC RN, you'll play an important role in helping people of various backgrounds and abilities live their lives the way they choose.

Knowledge/Skills/Abilities

• Provides personal care assessments and oversight to the My Cares Groups by administering the Wisconsin Personal Care Screening Tool and addendums as required.

• Documents assessment as required by individual tool and Department of Health Services policies, and by completing oversight visits and calls as required.

• Oversees a My Cares Groups of participants, develops individual plans of care, ensures physician orders for care are obtained and reviews and revises plan of care as needed

• Submits for Prior Authorization for personal care services.

• Complies with all Department of Health Services policies and SDPC Guidelines, procedures, and practices along with documentation and program regulations.

• Provides personal care training to participants or care providers as requested and provides educational materials as needed.

• Completes collateral contacts with IRIS Consultants and Long-Term Care Functional Screeners and physicians to ensure care needs are met.

• Completes other duties as assigned.

Job Qualifications

REQUIRED EDUCATION:

Associates Degree in Nursing

REQUIRED EXPERIENCE:

• Minimum 2 years of experience in nursing with at least one year of home health serving individuals with developmental disabilities, physical disabilities, or the elderly.

• Demonstrated computer and software skills required, proficiency with Microsoft Office Suite and database operation/maintenance skills and data entry experience.

• Excellent written and verbal communication skills required and the ability to adapt communication styles to fit situation.

• Strong teaching and mentoring skills.

• Strong analytical and problem-solving skills.

• Good organizational and time management skills with ability to manage tasks independently.

• Flexibility in the work environment and willingness and ability to adapt to changing organizational needs.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

Current unrestricted license in the state of Wisconsin as a Registered Nurse.

Valid Driver's License

PREFERRED EDUCATION:

Bachelor's Degree in Nursing

PREFERRED EXPERIENCE:

Experience providing care through the Wisconsin Medicaid Personal Care Program or one year of home care experience

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $26.41/hr - $51.49/hr*

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

#PJHS

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

Molina 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 members 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.

Job Duties

• Assist with housing search and placement along with leveraging supportive services that will assist members at risk of homelessness or discharged from institutions and state centers with maintaining permanent housing and promoting self-sufficiency, including integration into the community. May work to identify other appropriate community residential options for members

• Ensures proper residential authorizations are in place if applicable

• Understand specific needs of the member needing resources, identify available options that are the most cost-effective, most integrated, and meet the outcomes of the members

• Assists with advocacy efforts related to broad-based solutions to help reduce barriers for members to access affordable housing.

• Provides a variety of office and field activities to manage and monitor a rapid re-housing/ transition-in-place program for members.

• Conducts intake interviews and assesses housing barriers of members experiencing homelessness to determine the member's housing and service needs, goals, and eligibility.

• Assists members with development of a strength-based, solution-focused individualized goal and action plan that promotes permanent housing and self-sufficiency.

• Develops an effective, timely referral network for the member to help ensure ongoing direction and support as needed (e.g., community agencies for assistance with budget counseling and education).

• Provides a resource for mediation and advocacy with landlords on the member's behalf to develop a workable plan to obtain and/or maintain housing.

• Participates in housing collaborative and other housing outreach events with the purpose of expanding resource base.

• Creates and maintains consistent communication channels, both verbal and written, between involved parties (e.g., tenant, landlord, referral source, collaborating agencies and public housing authorities).

• Participates in the interdisciplinary care team (ICT) of members needing supportive housing services.

• Provides information and referral assistance regarding available support from appropriate social service agencies and/or community programs by maintaining a housing resource guide.

• Conducts proactive follow-up home visits to ensure stability and further progress towards member self-sufficiency, which may include support, advocacy, reducing isolation, listening, problem solving, and identification of resources to assist with reintegration of member into the community.

• Maintains accurate daily log records, monthly outcome reports, and files for each client. Collects and reports program data as required.

• 5 - 25% local travel required.

JOB QUALIFICATIONS

REQUIRED EDUCATION :

Bachelor's Degree (or equivalent combination of education and relevant experience in lieu of degree)

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :

• Minimum 2 years' experience working with underserved or special needs populations, with varied health, economic and educational circumstances.

• Experience with affordable housing and/or related community resources and social services.

• Knowledge of applicable state and federal guidelines/regulations (e.g., the Fair Housing Act and the rights of people with disabilities under Section 504 of the Rehabilitation Act of 1973).

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION :

Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

PREFERRED EDUCATION :

Bachelor's Degree in a human services or healthcare-related field.

PREFERRED EXPERIENCE :

• Bilingual based on community need.

• Familiarity with healthcare systems/processes, NCQA, and Interqual a plus.

• Knowledge of community-specific culture.

• Experience working with persons who have severe and persistent mental illness, behaviors, and/or AODA issues

• Experience developing care/case management plans.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION :

• Current Community Health Worker (CHW) Certification preferred (mandated in Ohio).

• Medical Assistant Certification

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

Molina 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.

KNOWLEDGE/SKILLS/ABILITIES

• 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.

• Conducts 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/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.

• 25- 40% local travel required.

• RNs provide consultation, recommendations and education as appropriate to non-RN case managers.

• RNs are assigned cases with members who have complex medical conditions and medication regimens

• RNs conduct medication reconciliation when needed.

JOB QUALIFICATIONS

Required Education

Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.

Required Experience

1-3 years in case management, disease management, managed care or medical or behavioral health settings.

Required License, Certification, Association

Active, unrestricted State Registered Nursing (RN) license 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.

Preferred Education

Bachelor's Degree in Nursing

Preferred Experience

3-5 years in case management, disease management, managed care or medical or behavioral health settings.

Preferred License, Certification, Association

Active, unrestricted Certified Case Manager (CCM)

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

TMG is on the lookout for our next great Eligibility Screener! If you love doing meaningful work that helps others live their best lives, we want to hear from you!

We're currently in search for someone with a background in human services, social work, healthcare or case management to join our team. This is a remote position, where you will partner with people in your community who use the TMG IRIS Consultant Agency. While this role is home-based, you will spend most days visiting IRIS participants in their homes. While you'll have a routine for the work that you do, no two days are alike!

As an Eligibility Screener, you would be responsible for completing the Adult Long-Term Care Functional Screens (LTC-FS) for participants of the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. The job includes completing annual rescreens and any change-in-condition screens using the Adult LTC-FS tool to ensure program eligibility. Successful candidates will be approachable, compassionate and respectful of people of all different backgrounds and abilities, and be able to see and articulate the strengths that people inherently have.

TMG is committed to maintaining a diverse and inclusive workforce, and prioritizes helping staff have a good work/life balance. Even though the position is remote, you'll have lots of support from your TMG team and coworkers across the organization. If this sounds like the job for you, apply today!

Job Duties

- Meets with IRIS participants face to face to complete the screening process.

- Completes the Adult Long Term Care Functional Screen (LTC-FS) for people in IRIS according to the Wisconsin Adult LTC-FS Instructions.

- Completes contacts to verify screen results with IRIS Consultants, Medicaid Personal Care agencies, and verifies diagnosis information with physicians and the Social Security Administration, when needed.

- Meets the highest standards of documentation and program regulations, while ensuring timely completion of screens.

- Maintains screening skills by participating in weekly team meetings, monthly All Screener Meetings, trainings and testing.

- Other duties as assigned by management.

Job Qualifications

REQUIRED EDUCATION :

Bachelor's Degree in a health or human services or related field. (e.g., social work, psychology) or graduate from an Accredited School of Nursing.

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :

• 1+ years of experience working with one of the target groups such as adults with physical or intellectual disabilities or older adults.

• Strong written and verbal communication skills; strong attention to detail.

• Demonstrated computer and software skills required; proficiency with Microsoft Office Suite and other software.

• Strong customer service skills.

• Good organizational and time management skills.

• The ability to work cooperatively as part of a team or autonomously

• Ability to remain flexible in the work environment and willing and able to adapt to changing organizational needs.

• Travel Requirements 5%

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION :

• Must pass the Wisconsin Adult Long-term Care Functional Screen certification modules (80% or higher on each module) within first week of hire and maintain certification as a screener.

• If a graduate from an Accredited School of Nursing, must have an active, unrestricted Wisconsin Registered Nursing (RN) license in good standing

• Must possess a valid driver's license, maintain adequate auto insurance for job-related travel and ability to travel throughout Wisconsin or other

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION :

Currently or formerly certified in the Long-Term Care Functional Screen.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $18.04/hr - $35.17/hr*

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

#PJHS

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

TMG is on the lookout for our next great Eligibility Screener! If you love doing meaningful work that helps others live their best lives, we want to hear from you!

We're currently in search for someone with a background in human services, social work, healthcare or case management to join our team. This is a remote position, where you will partner with people in your community who use the TMG IRIS Consultant Agency. While this role is home-based, you will spend most days visiting IRIS participants in their homes. While you'll have a routine for the work that you do, no two days are alike!

As an Eligibility Screener, you would be responsible for completing the Adult Long-Term Care Functional Screens (LTC-FS) for participants of the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. The job includes completing annual rescreens and any change-in-condition screens using the Adult LTC-FS tool to ensure program eligibility. Successful candidates will be approachable, compassionate and respectful of people of all different backgrounds and abilities, and be able to see and articulate the strengths that people inherently have.

TMG is committed to maintaining a diverse and inclusive workforce, and prioritizes helping staff have a good work/life balance. Even though the position is remote, you'll have lots of support from your TMG team and coworkers across the organization. If this sounds like the job for you, apply today!

Job Duties

- Meets with IRIS participants face to face to complete the screening process.

- Completes the Adult Long Term Care Functional Screen (LTC-FS) for people in IRIS according to the Wisconsin Adult LTC-FS Instructions.

- Completes contacts to verify screen results with IRIS Consultants, Medicaid Personal Care agencies, and verifies diagnosis information with physicians and the Social Security Administration, when needed.

- Meets the highest standards of documentation and program regulations, while ensuring timely completion of screens.

- Maintains screening skills by participating in weekly team meetings, monthly All Screener Meetings, trainings and testing.

- Other duties as assigned by management.

Job Qualifications

REQUIRED EDUCATION :

Bachelor's Degree in a health or human services or related field. (e.g., social work, psychology) or graduate from an Accredited School of Nursing.

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :

• 1+ years of experience working with one of the target groups such as adults with physical or intellectual disabilities or older adults.

• Strong written and verbal communication skills; strong attention to detail.

• Demonstrated computer and software skills required; proficiency with Microsoft Office Suite and other software.

• Strong customer service skills.

• Good organizational and time management skills.

• The ability to work cooperatively as part of a team or autonomously

• Ability to remain flexible in the work environment and willing and able to adapt to changing organizational needs.

• Travel Requirements 5%

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION :

• Must pass the Wisconsin Adult Long-term Care Functional Screen certification modules (80% or higher on each module) within first week of hire and maintain certification as a screener.

• If a graduate from an Accredited School of Nursing, must have an active, unrestricted Wisconsin Registered Nursing (RN) license in good standing

• Must possess a valid driver's license, maintain adequate auto insurance for job-related travel and ability to travel throughout Wisconsin or other

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION :

Currently or formerly certified in the Long-Term Care Functional Screen.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $18.04/hr - $35.17/hr*

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

#PJHS

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you'll want to keep reading about this rewarding work opportunity!

We are currently looking for a Registered Nurse licensed in Wisconsin to become our next IRIS Self-Directed Personal Care (SDPC) RN. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. People in the IRIS program who need personal care services have the choice to enroll in the IRIS Self-Directed Personal Care (IRIS SPDC) option. You can learn more about IRIS SDPC on the Wisconsin Department of Health Services website here (https://dhs.wisconsin.gov/iris/sdpc.htm) , and learn about the IRIS program here (https://dhs.wisconsin.gov/iris/index.htm) . While this role is home-based, you will have regularly scheduled visits with people in their homes and communities.

As an IRIS SDPC RN, you'll provide oversight and guidance to the people enrolled in the IRIS SDPC option. You'll also build relationships with the people you partner with and ensure that they're getting the most out of the IRIS Self-Directed Personal Care option through assessment, oversight, training and education.

IRIS SDPC RNs are responsible for administering the Wisconsin Personal Care Screening Tool; creating person-centered plans of care; providing personal care oversight to a group of people in IRIS, providing education and training for IRIS participants and care providers, and conducting the required documentation and follow-up. As an IRIS SDPC RN, you'll play an important role in helping people of various backgrounds and abilities live their lives the way they choose.

Knowledge/Skills/Abilities

• Provides personal care assessments and oversight to the My Cares Groups by administering the Wisconsin Personal Care Screening Tool and addendums as required.

• Documents assessment as required by individual tool and Department of Health Services policies, and by completing oversight visits and calls as required.

• Oversees a My Cares Groups of participants, develops individual plans of care, ensures physician orders for care are obtained and reviews and revises plan of care as needed

• Submits for Prior Authorization for personal care services.

• Complies with all Department of Health Services policies and SDPC Guidelines, procedures, and practices along with documentation and program regulations.

• Provides personal care training to participants or care providers as requested and provides educational materials as needed.

• Completes collateral contacts with IRIS Consultants and Long-Term Care Functional Screeners and physicians to ensure care needs are met.

• Completes other duties as assigned.

Job Qualifications

REQUIRED EDUCATION:

Associates Degree in Nursing

REQUIRED EXPERIENCE:

• Minimum 2 years of experience in nursing with at least one year of home health serving individuals with developmental disabilities, physical disabilities, or the elderly.

• Demonstrated computer and software skills required, proficiency with Microsoft Office Suite and database operation/maintenance skills and data entry experience.

• Excellent written and verbal communication skills required and the ability to adapt communication styles to fit situation.

• Strong teaching and mentoring skills.

• Strong analytical and problem-solving skills.

• Good organizational and time management skills with ability to manage tasks independently.

• Flexibility in the work environment and willingness and ability to adapt to changing organizational needs.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

Current unrestricted license in the state of Wisconsin as a Registered Nurse.

Valid Driver's License

PREFERRED EDUCATION:

Bachelor's Degree in Nursing

PREFERRED EXPERIENCE:

Experience providing care through the Wisconsin Medicaid Personal Care Program or one year of home care experience

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $18.04/hr - $35.17/hr*

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

#PJHS

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you'll want to keep reading about this rewarding work opportunity!

We are currently looking for a Registered Nurse licensed in Wisconsin to become our next IRIS Self-Directed Personal Care (SDPC) RN. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. People in the IRIS program who need personal care services have the choice to enroll in the IRIS Self-Directed Personal Care (IRIS SPDC) option. You can learn more about IRIS SDPC on the Wisconsin Department of Health Services website here (https://dhs.wisconsin.gov/iris/sdpc.htm) , and learn about the IRIS program here (https://dhs.wisconsin.gov/iris/index.htm) . While this role is home-based, you will have regularly scheduled visits with people in their homes and communities.

As an IRIS SDPC RN, you'll provide oversight and guidance to the people enrolled in the IRIS SDPC option. You'll also build relationships with the people you partner with and ensure that they're getting the most out of the IRIS Self-Directed Personal Care option through assessment, oversight, training and education.

IRIS SDPC RNs are responsible for administering the Wisconsin Personal Care Screening Tool; creating person-centered plans of care; providing personal care oversight to a group of people in IRIS, providing education and training for IRIS participants and care providers, and conducting the required documentation and follow-up. As an IRIS SDPC RN, you'll play an important role in helping people of various backgrounds and abilities live their lives the way they choose.

Knowledge/Skills/Abilities

• Provides personal care assessments and oversight to the My Cares Groups by administering the Wisconsin Personal Care Screening Tool and addendums as required.

• Documents assessment as required by individual tool and Department of Health Services policies, and by completing oversight visits and calls as required.

• Oversees a My Cares Groups of participants, develops individual plans of care, ensures physician orders for care are obtained and reviews and revises plan of care as needed

• Submits for Prior Authorization for personal care services.

• Complies with all Department of Health Services policies and SDPC Guidelines, procedures, and practices along with documentation and program regulations.

• Provides personal care training to participants or care providers as requested and provides educational materials as needed.

• Completes collateral contacts with IRIS Consultants and Long-Term Care Functional Screeners and physicians to ensure care needs are met.

• Completes other duties as assigned.

Job Qualifications

REQUIRED EDUCATION:

Associates Degree in Nursing

REQUIRED EXPERIENCE:

• Minimum 2 years of experience in nursing with at least one year of home health serving individuals with developmental disabilities, physical disabilities, or the elderly.

• Demonstrated computer and software skills required, proficiency with Microsoft Office Suite and database operation/maintenance skills and data entry experience.

• Excellent written and verbal communication skills required and the ability to adapt communication styles to fit situation.

• Strong teaching and mentoring skills.

• Strong analytical and problem-solving skills.

• Good organizational and time management skills with ability to manage tasks independently.

• Flexibility in the work environment and willingness and ability to adapt to changing organizational needs.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

Current unrestricted license in the state of Wisconsin as a Registered Nurse.

Valid Driver's License

PREFERRED EDUCATION:

Bachelor's Degree in Nursing

PREFERRED EXPERIENCE:

Experience providing care through the Wisconsin Medicaid Personal Care Program or one year of home care experience

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $26.41/hr - $51.49/hr*

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

#PJHS

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

Molina 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.

We are looking for Registered Nurse Case Manager with strong organizational and time management skills. Experience with Annual HRA assessments, Transition of Care Assessments and creating /managing Care plans highly preferred. The Case Manager will conduct Home visits as needed.

Remote position within the New York city, Brooklyn area

KNOWLEDGE/SKILLS/ABILITIES

• 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.

• Conducts 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/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.

• 25- 40% local travel required.

• RNs provide consultation, recommendations and education as appropriate to non-RN case managers.

• RNs are assigned cases with members who have complex medical conditions and medication regimens

• RNs conduct medication reconciliation when needed.

JOB QUALIFICATIONS

Required Education

Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.

Required Experience

1-3 years in case management, disease management, managed care or medical or behavioral health settings.

Required License, Certification, Association

Active, unrestricted State Registered Nursing (RN) license 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.

NY license

Preferred Education

Bachelor's Degree in Nursing

Preferred Experience

3-5 years in case management, disease management, managed care or medical or behavioral health settings.

Preferred License, Certification, Association

Active, unrestricted Certified Case Manager (CCM)

Annual HRA assessments

Experience with Transition of Care Assessments, managing Care plans

Experience conducting home visits

Pay Range: $26.41 - $51.49 per hour*

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

We have an extensive training program for new Grads!

Molina Student Loan Payment program available to Nurse Practitioners

Job Summary

The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, community, and nursing facility settings. Provides needed care in the environment that patients feel most comfortable and are most receptive including home, nursing facilities, and -pop up- clinic.

The Nurse Practitioner will be required to work primarily in non-clinical settings and provide medical care to all levels of patients. Some programs may focus on specific populations (e.g., adult and geriatric, pediatric, women's health).

Perform comprehensive medical assessments, order appropriate tests/procedures for diagnostic purposes, formulate treatment plans, obtain specialists' consultations as needed, and do appropriate documentations as required.

Job Duties

• Provide general medical care and care coordination to various and/or specific patient levels - adults, women's health, pediatric, and geriatric.

• Perform comprehensive evaluations including history and physical exams for gaps in care and preventative assessments

• Address both chronic and acute primary care complaints, and able to ascertain medical urgency

• Establish and document reasonable medical diagnoses

• Seek specialty consultation as appropriate

• Order/perform pertinent diagnostic laboratory and radiology testing for the medical diagnosis or presenting symptom; able to work within an environment of limited resources and therefore uses diagnostic tests judiciously and appropriately

• Responsible for knowing when a patient's needs are beyond their scope of knowledge and when physician oversight is needed.

• Create and implements a medical plan of care

• Schedule patient appointments for telehealth or in-person visits when appropriate

• Provide post discharge coordination to reduce hospital readmission rates and emergency room utilization

• Perform face-to-face in-person visits in a variety of settings including home, skilled nursing facilities, and public locations.

• Additionally, may perform face-to-face synchronous video communications using Telehealth platform based on business need, leadership direction, and state regulations

• Order bulk laboratory orders to target specific populations of member.

• Perform alternating on-call coverage to triage any urgent lab results and pharmacy inquiries and develop appropriate plan of care

• Participate in community-based -Pop Up Clinics- as way of building relationship with community while addressing gaps in health care

• Drive up to 120 miles a day on a regular basis to a variety of locations within the assigned region. There may be drives beyond 120 miles as part of Extended Mileage Special Project days.

• Obtain and maintain cross state license in other states besides home state based on business need.

• Collaborate with fellow nurse practitioners to develop best practices to perform work duties efficiently and effectively

• Actively participate in regional meetings

• Prescribe medications and perform procedures as appropriate

• Perform timely documentation in medical records in an electronic medical record computer system

• On occasion, may be required to walk flights of stairs while carrying up to 50 lbs. of equipment

JOB QUALIFICATIONS

REQUIRED EDUCATION:

Master's degree in family health from accredited nursing program

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

Advanced computer skills. Proficient with Word, Excel, and Electronic Medical Record.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

• An active and unrestricted national certification from one of the following organizations: American Academy of Nurse Practitioners; American Nurses Credentialing Center

• Current state-issued license to practice as a Family Nurse Practitioner

• Current Basic Life Support for Healthcare Professional certification

• Current unrestricted driver's license

PREFERRED EDUCATION:

PREFERRED EXPERIENCE:

• 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a home health, community health, or public health setting

• Previous experience in home health as a licensed clinician, especially in management of chronic conditions

• Experience with underserved populations facing socioeconomic barriers to health care

• Fluency in a language in addition to English is plus

• Immunization and point of care testing skills

Pay Range: $80,412.03 - $156,803.45 a year*

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

Responsible for achieving established goals improving Molina's enrollment growth objectives encompassing Medicaid programs. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages.

KNOWLEDGE/SKILLS/ABILITIES

• Under limited supervision, responsible for carrying out enrollment events and achieving assigned membership growth targets through a combination of direct and indirect marketing activities, with the primary responsibility of improving the plan's overall -choice- rate. Works collaboratively with other key departments to increase the Medicaid assignment percentage for Molina.

• Works closely with other team members and management to develop/maintain/deepen relationships with key business leaders, community-based organizations (CBOs) and providers, ensuring all efforts are directed towards building membership for Medicaid and related programs. Effectively moves relationships through the -enrollment- pipeline.

• Responsible for achieving monthly, quarterly, and annual enrollment goals, and growth and choice targets, as established by management.

• Schedules, coordinates & participates in enrollment events, encourages key partners to participate, and assists where feasible.

• Works cohesively with Provider Services to ensure providers within assigned territory are aware of Molina products and services. Establishes simple referral processes for providers and CBOs to refer clients who may be eligible for other Molina products.

• Viewed as a -subject matter expert- (SME) by community and influencers on the health care delivery system and wellness topics.

• Delivers presentations, attends meetings and distributes educational materials to both members and potential members.

• Assists with all incoming calls and assist perspective members or members with health access related questions.

• Identify partnerships with key sponsorship opportunities and provide justification to determine Molina's participation.

• Identify and promote Molina's programs out in the community and creates opportunities for employees to participate.

• Responsible for managing their own daily schedule in alignment with department goals and initiatives as assigned by regions.

• Key in the development of SMART goals and provide input on department priorities.

JOB QUALIFICATIONS

Required Education:

Bachelor's Degree or equivalent, job-related experience.

Required Experience:

• Min. 3 years of related experience (e.g., marketing, business development, community engagement, healthcare industry).

• Demonstrated exceptional networking and negotiations skills.

• Demonstrated strong public speaking and presentations skills.

• Demonstrated ability to work in a fast-paced, team-oriented environment with little supervision.

• Must be able to attend public events in outdoor venues in all weather conditions.

• Must be able to sit and stand for long periods.

• Must be able to drive up to 3 hours to attend events. Must be able to lift 30 pounds.

Required License, Certification, Association:

• Completion of Molina /DHS/MRMIB Marketing Certification Program/Covered CA Certified.

• Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

Preferred Education:

• Bachelor's Degree in Marketing or related discipline.

Preferred Experience:

• Solid understanding of Health Care Markets, primarily Medicaid.

• Previous healthcare marketing, enrollment and/or grassroots/community outreach experience a plus.

• 5 years of outreach experience serving low-income populations.

• 3 - 5 years project management experience, preferably in a health care or outreach setting.

• Experience presenting to influencer and low-income audiences.

• Experience in sales or marketing techniques.

• Fluency in a second language highly desirable.

Preferred License, Certification, Association:

• Active Life & Health Insurance

• Market Place Certified

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Detail

• Company:
  Molina Healthcare