Freelance Remote Claims Data Entry Jobs in Murrells Inlet, SC

 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. This is a remote role that works telephonically to support our members. 
 

Essential Job Duties

Completes comprehensive behavioral health assessments of members per regulated timelines and determines who may qualify for care coordination/case management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. 
Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate healthcare 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 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. 
 

Required Qualifications

At least 2 years health care experience, preferably in behavioral health, or equivalent combination of relevant education and experience. 
Licensed behavioral health clinician to include: Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Advanced Practice Social Worker (APSW), 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. If licensed, license must be active and unrestricted in state of practice. 
Experience with working with persons with severe and persistent mental health concerns and serious emotional disturbances, to include substance use disorder and foster care. 
Knowledge and experience related to whole person care principles, chronic health conditions, and discharge planning coordination. 
Data entry skills and previous experience utilizing a clinical platform. 
Excellent verbal and written communication skills. 
Microsoft Office suite/applicable software program(s) proficiency. 
 Preferred Qualifications

Certified Case Manager (CCM). 
Experience in behavioral health care management. 
Field-based care management or home health experience.

• There is a strong preference for two years of post-master's level degree work experience. 
• Technology savvy with an ability to use multiple systems and software simultaneously. 
• Attention to detail and ability to multi-task. 
  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: $25.08 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.