Remote Rn Case Manager Jobs in Spring Hill, FL (NOW HIRING)

JOB DESCRIPTION Job Summary

This position will offer remote work flexibility but the selected individual will need to reside in Florida. 

Leads and manages team of advanced practice practitioners - focusing on clinical care implementation, quality assurance and internal/external relationship development to meet current and future member needs. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• Leads team of nurse practitioners and physician assistants - ensuring quality clinical care for members that is cost-effective and person-centered.
• Leads organizational efforts to ensure timely completion of deliverables assigned to the advanced practice team.
• Serves as a representative for company at external workgroups and meetings, and provides advance practice representation.
• Coordinates and facilitates advanced practice practitioner meetings, including developing agendas and arranging speakers.
• Serves as liaison with staff, community clinicians and various internal departments to provide clinical care guidance and support for members.
• Collaborates with internal departments and community partners on clinical care quality focused improvements, evaluation and initiatives.
• Assists with implementation of key strategic organizational initiatives, focusing on clinical care and population health.
• Participates in utilization management and develops strategies based upon fiscal utilization trends and patterns identified through data in regard to clinical care of members.
• Establishes and maintains partnerships internally and externally to ensure appropriate utilization of services and knowledge surrounding member clinical care, including long-term care services.
• Assists with policy, procedure and guideline development.
• Provides direct supervision to assigned team and demonstrates accountability for performance.
• Local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 7 years of experience in health care, including 5 or more years as a physician assistant or nurse practitioner working with the geriatric and/or disabled populations, or equivalent combination of relevant education and experience.
• At least 1 year health care management/leadership experience.
• Physician Assistant (PA) or Advanced Practice Registered Nurse (APRN) through American Nurses Credentialing Center (ANCC) or American Association of Nurse Practitioners (AANP). License must be active and unrestricted in state of practice.
• Drug Enforcement Administration (DEA) license. License must be active and unrestricted in state of practice.
• For nurse practitioner, must be a graduate of an accredited nurse practitioner program. For physician assistant, must be a graduate of an accredited physician assistant studies program
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements.
• Ability to share information effectively with a diverse population.
• Ability to maintain schedules, meet deadlines and manage multiple projects.
• Ability to think critically and demonstrate solution-oriented results in a fast-paced environment.
• Ability to manage change, deal with situations as they arise, and work independently or as part of a team.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

• Medicaid and/or Medicare community-based program experience.
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: $107,028 - $208,705.4 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.