Nurse Manager jobs at Humana - 158 jobs

The Telephonic Case Manager RN in Medical Oncology provides remote nursing support by coordinating patient care, educating members, and ensuring adherence to treatment plans. This role involves assessing patient health, identifying barriers, and connecting patients with necessary resources to improve health outcomes. Working primarily via telephone, the position requires strong clinical expertise, communication skills, and proficiency in healthcare technology systems. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today! The Telephonic Case Manager RN Medical/Oncology will identify, coordinate, and provide appropriate levels of care. The Telephonic Case Manager RN Medical/Oncology is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. This is a full-time, Monday - Friday, 8am-5pm position in your time zone. You'll enjoy the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Make outbound calls and receive inbound calls to assess members current health status Identify gaps or barriers in treatment plans Provide patient education to assist with self-management Make referrals to outside sources Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Solid computer and software navigation skills are critical. You should also be solidly patient-focused and adaptable to changes. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Current, unrestricted RN license in state of residence Active Compact RN License or ability to obtain upon hire 3+ years of experience in a hospital, acute care or direct care setting Proven ability to type and have the ability to navigate a Windows based environment Have access to high-speed internet (DSL or Cable) Dedicated work area established that is separated from other living areas and provides information privacy Preferred Qualifications BSN Certified Case Manager (CCM) 1+ years of experience within Medical/Oncology Case management experience Experience or exposure to discharge planning Experience in a telephonic role Background in managed care *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Keywords: telephonic case management, oncology nurse, patient education, care coordination, medical management, healthcare advocacy, remote nursing, chronic disease management, UnitedHealth Group, RN license

Provides empathetic pharmacy consulting services to patients regarding the effective use of medications and drug interaction awareness. Offers preventive and clinical healthcare services, including immunizations, diagnostic testing, and patient outcome services. Ensures prescribed medications are compounded, reviewed, dispensed, and verified accurately according to regulatory guidelines and company policies and procedures. Manages an efficient pharmacy workflow and improves pharmacy financials, manages inventory effectively, and enhances patient experience. Manages pharmacy staff performance and engagement. Ensures the professional development of pharmacy staff by overseeing training, focused coaching, and executing formal performance management initiatives. Job Responsibilities: Patient Experience Engages patients by greeting them and offering assistance with products and services. Resolves patient issues in a timely manner and answers questions to ensure a positive patient experience. Models and shares customer service best practices with all team members to deliver a distinctive and joyful patient experience, including interpersonal habits that show care (e.g., greeting, eye contact, courtesy, etc.) and Walgreens service traits (e.g., demonstrating curiosity to identify needs and proactively helping, servicing until satisfied, championing empathy and inclusivity, etc.). Connects with patients by anticipating needs and proactively offering services. Leads efforts on enhancing patient experience by increasing awareness of healthcare services offered through Walgreens (e.g. patient consultation, medication management, drug therapy reviews, and perform clinical, or wellness services such as immunizations, diagnostic testing, and patient outcomes services) thereby promoting the shift of the Walgreen's pharmacy role from transactional to interpersonal. Participates and assists in events that reflect the unique communities we serve as requested by Store Manager, Healthcare Supervisor, or District Manager. Operations Counsels patients and answers questions regarding usage of medicine, side effects, interactions, contraindications, patient information privacy, generics, less expensive medicines, and over-the-counter products. Refers to the medical provider, as needed, to ensure medication is taken correctly, health needs are addressed, and patient is satisfied with service. Performs pharmacist tasks including compounding, drug therapy reviews, verification, and medication management. Reviews, interprets, and accurately dispenses prescribed medications, as required. Ensures the pharmacy operates in accordance with regulations, company policies and standards. Establishes procedures that promote the efficient workflow of the pharmacy including overseeing staff scheduling, assigning roles, coordinating activities, and soliciting team member suggestions. Responsible for opening and closing the pharmacy and shift changes. Ensures the use of all elements of the Good Faith Dispensing policy in conjunction with state and federal controlled substance laws when filling prescriptions. The Product Review/Retail Fill Process Pharmacist is responsible for ensuring that elements of Good Faith are present. Collaborates with Store Manager to define and develop new strategic business opportunities. Maintains information technology knowledge of pharmacy systems including workflow, prescription fulfillment, billing, clinical documentation, training, inventory management, and point of sale registers. Supports pharmacy staff and patients with information technology. Finds opportunities to improve productivity Ensures insurance claims are processed accurately to prevent payment rejections. Resolves patient issues by working with insurance companies and medical providers and conducting or participating in third party audits. Follows-up with medical providers to clarify prescribed medications, dosages, refills, interactions, and allergies to suggest alternative medications, and answer medical provider questions. diagnostic testing, disease state management and other healthcare services. Performs clinical and wellness services such as immunizations, diagnostic testing, disease state management, and other healthcare services Partners with centralized support for patient registration, exception resolution, and assists with resolving patient issues. In virtual environments, conducts virtual product review by following specific company procedures and guidelines Manages the maintenance, housekeeping, and improvement of the pharmacy department including repairs, cleaning, new equipment, and layout changes to ensure a functioning, presentable and efficient pharmacy. Prepares and submits all records, reports, and other documentation as required by state and federal laws to run the pharmacy business (e.g., operating statements, performance indicator reports, supervision notes, deletions, transfers.) People & Performance Management Collaborates with Store Manager on pharmacy staff hiring, carries out discipline and termination, as necessary, and ensures compliance with employment laws. Partners with Store Manager to establish expectations and goals, promote teamwork and foster a shared vision. Monitors and recognizes improvements in pharmacy staff by implementing rewards programs. Manages pharmacy staff performance by overseeing the training of pharmacy staff (e.g., using the correct processes and tools) and conducting formal performance reviews. Identifies high potential team members and proactively collaborates with Store Manager to manage career progression. Addresses employee relations concerns. Maintains team member morale by checking on employee welfare, addressing complaints and conflicts, and ensuring positive employee management relationship. Training & Personal Development Maintains required licensing/credentialing/certification as established by federal and state regulations to provide clinical services. Maintains and enhances current knowledge and skills related to pharmacy and healthcare by reading pharmacy related journals and Walgreens publications and communications. Maintains awareness of developments in retail and management areas and pursues best practices to enhance business acumen and pharmacy performance. Completes education credits and training, including learning modules, as required by the Company Seeks professional development by monitoring own performance, solicits constructive feedback, and leverages Healthcare Supervisor and Store Manager as mentors and coaches. Communications Supports the Store Manager by communicating relevant corporate health and wellness services or strategy information to pharmacy staff. Business Performance Management Analyzes performance data including pharmacy financials, customer service, and inventory. Manages pharmacy asset protection activities and oversees inventory management. Identifies pharmacy performance trends and opportunities for improvement. Business Planning Develops and maintains good relationships with local medical community including physicians, nurses, and other health care providers. Reaches out to the community to promote the pharmacy business and further enhance growth opportunities. Supports Store Manager in expanding health and wellness awareness in the community Basic Qualifications BS in Pharmacy or Pharm D Degree from an accredited educational institution. Current pharmacist licensure in the states within the district. Certified Immunizer or willing to become an immunizer within 90 days of hire. At least 1 year pharmacy experience including prescription filling, recordkeeping, legal compliance, pharmacy operations, pharmacy software and technology systems and insurance billing. (Some states may require more specific pharmacy experience in which case those requirements would take precedent). Experience performing prescription dispensing activities that demonstrate a strong working knowledge of applicable state and federal controlled substance laws. An average rating of at least 3.0 on the leadership behaviors on the last performance review if one is on file, and no written disciplinary actions in the last 12 months (Internal candidates only). About Walgreens Founded in 1901, Walgreens (****************** proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities. Preferred Qualifications Supervisory experience planning, organizing, and directing the work of pharmacy staff. At least 6 months pharmacy experience with Walgreen Co. An average rating of 3.7 or above on the leadership behaviors on the last performance review if one is on file. (Internal candidates only) An Equal Opportunity Employer, including disability/veterans We will consider employment of qualified applicants with arrest and conviction records. The Salary below is being provided to promote pay transparency and equal employment opportunities at Walgreens. The actual salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits Salary Range: Pharmacy Manager $5,863.20-$6,438.20 Bi-Weekly

Provides empathetic pharmacy consulting services to patients regarding the effective use of medications and drug interaction awareness. Offers preventive and clinical healthcare services, including immunizations, diagnostic testing, and patient outcome services. Ensures prescribed medications are compounded, reviewed, dispensed, and verified accurately according to regulatory guidelines and company policies and procedures. Manages an efficient pharmacy workflow and improves pharmacy financials, manages inventory effectively, and enhances patient experience. Manages pharmacy staff performance and engagement. Ensures the professional development of pharmacy staff by overseeing training, focused coaching, and executing formal performance management initiatives. Job Responsibilities: Patient Experience Engages patients by greeting them and offering assistance with products and services. Resolves patient issues in a timely manner and answers questions to ensure a positive patient experience. Models and shares customer service best practices with all team members to deliver a distinctive and joyful patient experience, including interpersonal habits that show care (e.g., greeting, eye contact, courtesy, etc.) and Walgreens service traits (e.g., demonstrating curiosity to identify needs and proactively helping, servicing until satisfied, championing empathy and inclusivity, etc.). Connects with patients by anticipating needs and proactively offering services. Leads efforts on enhancing patient experience by increasing awareness of healthcare services offered through Walgreens (e.g. patient consultation, medication management, drug therapy reviews, and perform clinical, or wellness services such as immunizations, diagnostic testing, and patient outcomes services) thereby promoting the shift of the Walgreen's pharmacy role from transactional to interpersonal. Participates and assists in events that reflect the unique communities we serve as requested by Store Manager, Healthcare Supervisor, or District Manager. Operations Counsels patients and answers questions regarding usage of medicine, side effects, interactions, contraindications, patient information privacy, generics, less expensive medicines, and over-the-counter products. Refers to the medical provider, as needed, to ensure medication is taken correctly, health needs are addressed, and patient is satisfied with service. Performs pharmacist tasks including compounding, drug therapy reviews, verification, and medication management. Reviews, interprets, and accurately dispenses prescribed medications, as required. Ensures the pharmacy operates in accordance with regulations, company policies and standards. Establishes procedures that promote the efficient workflow of the pharmacy including overseeing staff scheduling, assigning roles, coordinating activities, and soliciting team member suggestions. Responsible for opening and closing the pharmacy and shift changes. Ensures the use of all elements of the Good Faith Dispensing policy in conjunction with state and federal controlled substance laws when filling prescriptions. The Product Review/Retail Fill Process Pharmacist is responsible for ensuring that elements of Good Faith are present. Collaborates with Store Manager to define and develop new strategic business opportunities. Maintains information technology knowledge of pharmacy systems including workflow, prescription fulfillment, billing, clinical documentation, training, inventory management, and point of sale registers. Supports pharmacy staff and patients with information technology. Finds opportunities to improve productivity Ensures insurance claims are processed accurately to prevent payment rejections. Resolves patient issues by working with insurance companies and medical providers and conducting or participating in third party audits. Follows-up with medical providers to clarify prescribed medications, dosages, refills, interactions, and allergies to suggest alternative medications, and answer medical provider questions. diagnostic testing, disease state management and other healthcare services. Performs clinical and wellness services such as immunizations, diagnostic testing, disease state management, and other healthcare services Partners with centralized support for patient registration, exception resolution, and assists with resolving patient issues. In virtual environments, conducts virtual product review by following specific company procedures and guidelines Manages the maintenance, housekeeping, and improvement of the pharmacy department including repairs, cleaning, new equipment, and layout changes to ensure a functioning, presentable and efficient pharmacy. Prepares and submits all records, reports, and other documentation as required by state and federal laws to run the pharmacy business (e.g., operating statements, performance indicator reports, supervision notes, deletions, transfers.) People & Performance Management Collaborates with Store Manager on pharmacy staff hiring, carries out discipline and termination, as necessary, and ensures compliance with employment laws. Partners with Store Manager to establish expectations and goals, promote teamwork and foster a shared vision. Monitors and recognizes improvements in pharmacy staff by implementing rewards programs. Manages pharmacy staff performance by overseeing the training of pharmacy staff (e.g., using the correct processes and tools) and conducting formal performance reviews. Identifies high potential team members and proactively collaborates with Store Manager to manage career progression. Addresses employee relations concerns. Maintains team member morale by checking on employee welfare, addressing complaints and conflicts, and ensuring positive employee management relationship. Training & Personal Development Maintains required licensing/credentialing/certification as established by federal and state regulations to provide clinical services. Maintains and enhances current knowledge and skills related to pharmacy and healthcare by reading pharmacy related journals and Walgreens publications and communications. Maintains awareness of developments in retail and management areas and pursues best practices to enhance business acumen and pharmacy performance. Completes education credits and training, including learning modules, as required by the Company Seeks professional development by monitoring own performance, solicits constructive feedback, and leverages Healthcare Supervisor and Store Manager as mentors and coaches. Communications Supports the Store Manager by communicating relevant corporate health and wellness services or strategy information to pharmacy staff. Business Performance Management Analyzes performance data including pharmacy financials, customer service, and inventory. Manages pharmacy asset protection activities and oversees inventory management. Identifies pharmacy performance trends and opportunities for improvement. Business Planning Develops and maintains good relationships with local medical community including physicians, nurses, and other health care providers. Reaches out to the community to promote the pharmacy business and further enhance growth opportunities. Supports Store Manager in expanding health and wellness awareness in the community Basic Qualifications BS in Pharmacy or Pharm D Degree from an accredited educational institution. Current pharmacist licensure in the states within the district. Certified Immunizer or willing to become an immunizer within 90 days of hire. At least 1 year pharmacy experience including prescription filling, recordkeeping, legal compliance, pharmacy operations, pharmacy software and technology systems and insurance billing. (Some states may require more specific pharmacy experience in which case those requirements would take precedent). Experience performing prescription dispensing activities that demonstrate a strong working knowledge of applicable state and federal controlled substance laws. An average rating of at least 3.0 on the leadership behaviors on the last performance review if one is on file, and no written disciplinary actions in the last 12 months (Internal candidates only). About Walgreens Founded in 1901, Walgreens (****************** proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities. Preferred Qualifications Supervisory experience planning, organizing, and directing the work of pharmacy staff. At least 6 months pharmacy experience with Walgreen Co. An average rating of 3.7 or above on the leadership behaviors on the last performance review if one is on file. (Internal candidates only) An Equal Opportunity Employer, including disability/veterans We will consider employment of qualified applicants with arrest and conviction records. The Salary below is being provided to promote pay transparency and equal employment opportunities at Walgreens. The actual salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits Salary Range: Pharmacy Manager $5,863.20-$6,438.20 Bi-Weekly

Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. * Facilitates comprehensive waiver enrollment and disenrollment processes. * Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care. * Assesses for medical necessity and authorizes all appropriate waiver services. * Evaluates covered benefits and advises appropriately regarding funding sources. * Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services 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 and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. * Identifies critical incidents and develops prevention plans to assure member health and welfare. * Collaborates with licensed care managers/leadership as needed or required. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. •Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. * In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Demonstrated knowledge of community resources. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work independently, with minimal supervision and self-motivation. * Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. * In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). Preferred Qualifications * Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. * Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $24 - $46.81 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of South Carolina and or compact license. Care Manager RN will work with Medicaid/Medicare SC population completing assessments, care plans, educating, and connecting to community resources. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members and providers on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Preferred experience working with a Behavioral Health population and/or Waiver program Home office with internet connectivity of high speed required. This is a remote position. Schedule: Monday thru Friday 8:00AM to 5:00PM EST. (Flexibility to work 1 to 2 nights a week to 6 PM EST) (No Weekends or Holidays) Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. * Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member caseload for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. * Facilitates interdisciplinary care team (ICT) 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. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs may conduct medication reconciliation as needed. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). * Demonstrated knowledge of community resources. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to work independently, with minimal supervision and self-motivation. * Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 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 - $61.79 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. * Facilitates comprehensive waiver enrollment and disenrollment processes. * Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care. * Assesses for medical necessity and authorizes all appropriate waiver services. * Evaluates covered benefits and advises appropriately regarding funding sources. * Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services 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 and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. * Identifies critical incidents and develops prevention plans to assure member health and welfare. * Collaborates with licensed care managers/leadership as needed or required. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. •Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. * In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Demonstrated knowledge of community resources. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work independently, with minimal supervision and self-motivation. * Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. * In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). Preferred Qualifications * Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. * Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $24 - $46.81 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. **Essential Job Duties** - Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. - Facilitates comprehensive waiver enrollment and disenrollment processes. - Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. - Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. - Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care. - Assesses for medical necessity and authorizes all appropriate waiver services. - Evaluates covered benefits and advises appropriately regarding funding sources. - Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services 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 and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. - Identifies critical incidents and develops prevention plans to assure member health and welfare. - May provide consultation, resources and recommendations to peers as needed. - 25-40% estimated local travel may be required (based upon state/contractual requirements). **Required Qualifications** - At least 2 years experience in health care, including at least 1 year of experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. - Licensed Clinical Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT, Doctor of Psychology (PhD or PsyD) or equivalency based on state contract, regulation, or state board licensing mandate. License must be active and unrestricted in state of practice. - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. - Demonstrated knowledge of community resources. - Ability to operate proactively and demonstrate detail-oriented work. - Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. - Ability to work independently, with minimal supervision and self-motivation. - Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. - Ability to develop and maintain professional relationships. - Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. - Excellent problem-solving, and critical-thinking skills. - Strong verbal and written communication skills. - Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. - In some states, must have at least one year of experience working directly with individuals with substance use disorders. **Preferred Qualifications** - Certified Case Manager (CCM). - Experience working with populations that receive waiver services. \#PJCorp \#LI-AC1 To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 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 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. * Facilitates comprehensive waiver enrollment and disenrollment processes. * Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care. * Assesses for medical necessity and authorizes all appropriate waiver services. * Evaluates covered benefits and advises appropriately regarding funding sources. * Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services 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 and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. * Identifies critical incidents and develops prevention plans to assure member health and welfare. * Collaborates with licensed care managers/leadership as needed or required. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. •Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. * In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Demonstrated knowledge of community resources. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work independently, with minimal supervision and self-motivation. * Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. * In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). Preferred Qualifications * Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. * Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $24 - $46.81 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Home office with internet connectivity of high speed required. Schedule: Monday thru Friday 8:00AM to 5:00PM Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (Columbus OH). (Mileage is reimbursed) JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. * Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member caseload for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. * Facilitates interdisciplinary care team (ICT) 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. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs may conduct medication reconciliation as needed. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). * Demonstrated knowledge of community resources. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to work independently, with minimal supervision and self-motivation. * Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 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 - $51.49 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

The Telephonic Case Manager RN in Medical Oncology provides remote nursing support by coordinating patient care, educating members, and ensuring adherence to treatment plans. This role involves assessing patient health, identifying barriers, and connecting patients with necessary resources to improve health outcomes. Working primarily via telephone, the position requires strong clinical expertise, communication skills, and proficiency in healthcare technology systems. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today! The Telephonic Case Manager RN Medical/Oncology will identify, coordinate, and provide appropriate levels of care. The Telephonic Case Manager RN Medical/Oncology is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. This is a full-time, Monday - Friday, 8am-5pm position in your time zone. You'll enjoy the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: • Make outbound calls and receive inbound calls to assess members current health status • Identify gaps or barriers in treatment plans • Provide patient education to assist with self-management • Make referrals to outside sources • Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction • Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Solid computer and software navigation skills are critical. You should also be solidly patient-focused and adaptable to changes. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • Current, unrestricted RN license in state of residence • Active Compact RN License or ability to obtain upon hire • 3+ years of experience in a hospital, acute care or direct care setting • Proven ability to type and have the ability to navigate a Windows based environment • Have access to high-speed internet (DSL or Cable) • Dedicated work area established that is separated from other living areas and provides information privacy Preferred Qualifications • BSN • Certified Case Manager (CCM) • 1+ years of experience within Medical/Oncology • Case management experience • Experience or exposure to discharge planning • Experience in a telephonic role • Background in managed care *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Keywords: telephonic case management, oncology nurse, patient education, care coordination, medical management, healthcare advocacy, remote nursing, chronic disease management, UnitedHealth Group, RN license

For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of South Carolina and or compact license. Care Manager RN will work with Medicaid/Medicare SC population completing assessments, care plans, educating, and connecting to community resources. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members and providers on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Preferred experience working with a Behavioral Health population and/or Waiver program Home office with internet connectivity of high speed required. This is a remote position. Schedule: Monday thru Friday 8:00AM to 5:00PM EST. (Flexibility to work 1 to 2 nights a week to 6 PM EST) (No Weekends or Holidays) Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. * Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member caseload for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. * Facilitates interdisciplinary care team (ICT) 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. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs may conduct medication reconciliation as needed. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). * Demonstrated knowledge of community resources. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to work independently, with minimal supervision and self-motivation. * Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 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 - $61.79 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of South Carolina and or compact license. Care Manager RN will work with Medicaid/Medicare SC population completing assessments, care plans, educating, and connecting to community resources. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members and providers on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Preferred experience working with a Behavioral Health population and/or Waiver program Home office with internet connectivity of high speed required. This is a remote position. Schedule: Monday thru Friday 8:00AM to 5:00PM EST. (Flexibility to work 1 to 2 nights a week to 6 PM EST) (No Weekends or Holidays) Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. * Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member caseload for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. * Facilitates interdisciplinary care team (ICT) 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. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs may conduct medication reconciliation as needed. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). * Demonstrated knowledge of community resources. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to work independently, with minimal supervision and self-motivation. * Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 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 - $61.79 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of South Carolina and or compact license. Care Manager RN will work with Medicaid/Medicare SC population completing assessments, care plans, educating, and connecting to community resources. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members and providers on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Preferred experience working with a Behavioral Health population and/or Waiver program Home office with internet connectivity of high speed required. This is a remote position. Schedule: Monday thru Friday 8:00AM to 5:00PM EST. (Flexibility to work 1 to 2 nights a week to 6 PM EST) (No Weekends or Holidays) Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. * Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member caseload for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. * Facilitates interdisciplinary care team (ICT) 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. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs may conduct medication reconciliation as needed. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). * Demonstrated knowledge of community resources. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to work independently, with minimal supervision and self-motivation. * Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 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 - $61.79 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of South Carolina and or compact license. Care Manager RN will work with Medicaid/Medicare SC population completing assessments, care plans, educating, and connecting to community resources. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members and providers on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Preferred experience working with a Behavioral Health population and/or Waiver program Home office with internet connectivity of high speed required. This is a remote position. Schedule: Monday thru Friday 8:00AM to 5:00PM EST. (Flexibility to work 1 to 2 nights a week to 6 PM EST) (No Weekends or Holidays) Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. * Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member caseload for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. * Facilitates interdisciplinary care team (ICT) 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. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs may conduct medication reconciliation as needed. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). * Demonstrated knowledge of community resources. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to work independently, with minimal supervision and self-motivation. * Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 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 - $61.79 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of South Carolina and or compact license. Care Manager RN will work with Medicaid/Medicare SC population completing assessments, care plans, educating, and connecting to community resources. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members and providers on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Preferred experience working with a Behavioral Health population and/or Waiver program Home office with internet connectivity of high speed required. This is a remote position. Schedule: Monday thru Friday 8:00AM to 5:00PM EST. (Flexibility to work 1 to 2 nights a week to 6 PM EST) (No Weekends or Holidays) Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. * Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member caseload for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. * Facilitates interdisciplinary care team (ICT) 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. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs may conduct medication reconciliation as needed. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). * Demonstrated knowledge of community resources. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to work independently, with minimal supervision and self-motivation. * Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 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 - $61.79 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Home office with internet connectivity of high speed required. Schedule: Monday thru Friday 8:00AM to 5:00PM Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (Columbus OH). (Mileage is reimbursed) JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. * Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member caseload for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. * Facilitates interdisciplinary care team (ICT) 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. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs may conduct medication reconciliation as needed. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). * Demonstrated knowledge of community resources. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to work independently, with minimal supervision and self-motivation. * Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 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 - $51.49 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Become a part of our caring community and help us put health first Enjoy a rewarding career with a true work/life balance-no nights or weekends, giving you more time for what matters most. Humana is currently seeking RN Case Managers to join our teams in the La Crosse and Sparta offices, serving members in the Wisconsin Family Care (FC) program. In this vital role, you will collaborate with dedicated colleagues to ensure exceptional care coordination for our members, providing crucial support and education to help them thrive in their daily lives. Take the next step in your nursing career and make a meaningful difference with Humana.Key responsiblities: Partner with a Care Coach (also referred to as a Case Manager), taking the lead on health-related needs, to collaborate on an ongoing basis regarding the member and their care plan. Conduct regular health assessments for members and implement appropriate strategies and services to develop individualized care plans that support their continued health and safety. Contribute to the creation, continuous evaluation, and coordination of the member's plan of care, including coordinating with outside providers to provide support with medication administration, assistance with home care, skilled nursing visits, and related services to ensure comprehensive care. Contact and coordinate with acute and primary care providers. Promote health and wellness through patient education on disease prevention, nutrition, exercise and lifestyle modifications. Provide members with education and information about disease processes and related risks, supporting informed decision-making while respecting each individual's autonomy. Daily documentation in member files within required DHS contract timeframes. Participate in member monthly phone contacts and attend in person visits in members setting. Traveling will be required and eligible for mileage reimbursement. Use your skills to make an impact Required Qualifications Associate degree in nursing. Must be a Registered Nurse, licensed in the state of Wisconsin in good standing. Demonstrated intermediate computer proficiency, including experience with Microsoft Office applications. Preferred Qualifications Bachelor degree in nursing. One (1)+ years of experience with Family Care target group: frail elders and adults with intellectual, developmental, or physical disabilities. Care Management experience Additional Information Workstyle: This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes. Work Location: Either La Crosse WI or Sparta WI and surrounding area. Travel: up to 40% throughout assigned area and surrounding areas Typical Work Days/Hours: Monday through Friday, 8:00 am - 4:30 pm CST. WAH Internet Statement To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Driving This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits. TB This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Modern Hire As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. SSN Alert Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. ****NOTE: This is a fully remote role with serving maternity and postnatal members with behavioral health conditions. Preference will be given to individuals who (1) possess an active Illinois registered nurse (RN) license, (2) have a combination of professional experience with high-risk maternity and behavioral health/substance use, as well as (3) virtual service coordination, case management, community advocacy. (4) Spanish language fluency is a plus. Additional Details: • Line of Business: Illinois Health Plan • Department: MED-Medical Management (Case Management) • Schedule: Monday through Friday, 8 AM to 5 PM Central • Caseload: behavioral health maternity members. **** Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs Identifies problems/barriers to care and provide appropriate care management interventions Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs Provides resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner Other duties or responsibilities as assigned by people leader to meet business needs Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 - 4 years of related experience. License/Certification: RN - Registered Nurse - State Licensure and/or Compact State Licensure required For YouthCare Illinois plan only: Bachelor's Degree and IL RN licensure required. Must reside in IL For Sunshine Health (FL) Only: Employees supporting Florida's Children's Medical Services (CMS) must have a minimum of two years of pediatric experience. May require up to 80% local travel required Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home. We're connecting care to create a seamless health journey for patients across care settings. Join us to start **Caring. Connecting. Growing together.** Registered Nurses in the Optum at Home program work with patients primarily in their home setting. They perform as part of a care team including a Nurse Practitioner, Behavioral Health Advocate, Care Navigator and other supporting team members. They deliver role appropriate patient care through in-home visits, telephonic outreach and consultations, and interdisciplinary team activities. The Field Case Manager RN may perform care and counsel of the ill, injured, or infirm, in the promotion and maintenance of health with individuals, groups, or both throughout the life span. They help to manage health problems and coordinate health care for the Optum at Home patients in accordance with State and Federal rules and regulations and the nursing standards of care. This includes (but is not limited to) assessment of health status, development and implementation of plan of care, and ongoing evaluation of patient status and response to the plan of care. Clinical management is conducted in collaboration with other care team members. **Primary Responsibilities:** + Reports to RN Manager + Assess the health status of members as within the scope of licensure and with the frequency established in the model of care + Establish goals to meet identified health care needs + Plan, implement and evaluate responses to the plan of care + Work collaboratively the multidisciplinary team to engage resources and strategies to address medical, functional, and social barriers to care + Works closely with mental health clinicians to help bridge the gap between mental and physical health + Consult with the patient's PCP, specialists, or other health care professionals as appropriate + Assess patient needs for community resources and make appropriate referrals for service + Facilitate the patient's transition within and between health care settings in collaboration with the primary care physician and other treating physicians + Completely and accurately document in patient's electronic medical record + Provide patients and family members with counseling and education regarding health maintenance, disease prevention, condition trajectory and need for follow up as appropriate during each patient visit + Verify and document patient and/or family understanding of condition, plan of care and follow up recommendations + Actively participate in organizational quality initiatives + Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness of care delivery + Maintain credentials essential for practice, to include licensure, certification (if applicable) and CEUs + Demonstrate a commitment to the mission, core values and goals of UnitedHealthcare and its healthcare delivery including the ability to integrate values of compassion, integrity, performance, innovation and relationships in the care provided to our member You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Years of post-high school education can be substituted/is equivalent to years of experience. **Required Qualifications:** + Current unrestricted licensure as RN in Ohio + 2+ years of relevant experience + Experience in assessing the medical needs of patients with complex behavioral, social and/or functional needs + Demonstrated ability to work with diverse care teams in a variety of settings including non-clinical settings (primarily patient homes) + Proven solid computer skills, including use of electronic medical records + Ability to travel 100% of the time for field-based work within 60 miles of residence + Valid driver's license + Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area **Preferred Qualification:** + Field based experience + Case management experience + Proven effective time management and communication skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._