Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. KNOWLEDGE/SKILLS/ABILITIES Completes comprehensive assessments of members per regulated …
RN Case Manager – must reside in Utah
RN Care Review Clinician Inpatient Review – CA
JOB DESCRIPTION For this position we are seeking a (RN) Registered Nurse with 3 years UM with outpatient prior authorization experience, Concurrent Review/ Utilization Review / Utilization Management and must have MCG guidelines experience. CURRENT RN CALIFORNIA LICENSURE IS REQUIRED FOR THIS POSITION. California is not a compact state at this time. Excellent computer skills and attention to detail are very important to multi task between systems, talk with members on the phone, and enter accurate contact notes. Virtual office …
Psych Case Manager (RN) – SC, FL, MS, OH only
JOB DESCRIPTION Fully remote, telephonic Case Manager opportunity for RN in Ohio, Mississippi, Florida, or South Carolina with robust experience in behavioral health. Experience as a Case Manager within another Manage Care Organization is preferred, and preference will be given to those candidates with a compact state license and willing to obtain other licenses if needed. Schedule is Monday – Friday, 8 AM – 5 PM, but there will also be Saturdays and non-traditional hours from time to time as …
IRIS Consultant (Milwaukee, Ozaukee, and Washington County) (Fieldwork/Hybrid) (No Weekends, No Holidays, No After Hours)
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Job Summary Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you! We’re currently looking for someone with a social services or human services background to join our team. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS …
IRIS Consultant – TMG (Must reside in Dane County, WI) (Fieldwork/Hybrid) (No Weekends, No Holidays, No After Hours)
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JOB DESCRIPTION Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you! We’re currently looking for someone with a social services or human services background to join our team. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS …
IRIS Consultant – TMG (Lafayette County) (Fieldwork/Hybrid) (No Weekends, No Holidays, No After Hours)
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Job Summary Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you! We’re currently looking for someone with a social services or human services background to join our team. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS …
IRIS Consultant – TMG (Milwaukee & Waukesha Counties) (Fieldwork/Hybrid) (No Weekends, No Holidays, No After Hours)
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Job Summary IRIS Consultants (IC) are home-based employee who partners with individuals enrolled in the IRIS program to identify their long-term care goals and find creative ways to achieve them. Role works in communities where IRIS self-directed long-term care is offered as an alternative to managed care under the Family Care program. This role is a steady, trusted partner, working side-by side with people enrolled in IRIS. This role builds upon the resources available in the community to help individuals …
Case Manager, LTSS (RN) – Waiver Program
JOB DESCRIPTION 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 MI. This position will support our MMP (Medicaid Medicare Population) that is part of the WAIVER team. This position will have a case load and manage members enrolled in this program. We are looking for Registered Nurses who have experience working with manage care population and/or case management role. Excellent computer skills and …
RN/LCSW Case Manager Maternal Health – Remote must reside in NV
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. KNOWLEDGE/SKILLS/ABILITIES Completes comprehensive assessments of members per regulated …