Job Description: M-F 8-5 MST
Qualified candidates must live in the state of NEW MEXICO.
Please clearly indicate where your candidate is located/ county on resumes.
If licensed, must be licensed for NEW MEXICO.- RN is not required.
• Will the position be 100% remote? Yes 100%, and at times will need to come to office for meetings and complete at least 40% of traveling for Assessments in Members home.
• Are there any specific location requirements? Must be in the following counties in NM.
1. Curry
2. De Baca
3. Quay
4. Roosevelt
• Are there are time zone requirements? 8-5p.m. Mountain time Monday through Friday.
• What are the must have requirements? See information in specific licensure
• Is there specific licensure is required in order to qualify for the role? 1-3 years in case management, disease management, managed care or medical or behavioral health settings or Bachelor's or Master's Degree (preferably in a social science, psychology, gerontology, public health or social work or related). 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:
Bachelor's Degree or 1 year of Care Coordination a minimum of one year of experience
•
• What are the day to day responsibilities? 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 members.
May implement specific wellness programs i.e. asthma and depression disease management.
Facilitates interdisciplinary care team meetings and informal ICT collaboration.
Uses motivational interviewing and 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 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
• What is the desired work hours (i.e. 8am – 5pm) 8-5p.m.
• What additional equipment besides a laptop, keyboard, mouse and headset will be required for this candidate to be successful in this role? (see below) laptop, keyboard, mouse, headset, also an IPAD will have to be issued.