Case Manager REMOTE, MIAMI DADE COUNTY, FLORIDA.
Job DescriptionJob SummaryMolina 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...