Field Nurse Case Manager Jobs in Massachusetts

JOB SUMMARY

Provides screening, preventive primary care and medical care services to members - primarily in non-clinical settings where members feel most comfortable, including in-home, community and nursing facilities and “pop up” clinics. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

ESSENTIAL JOB DUTIES

- Provides general medical care and care coordination to various and/or specific patient member populations – adult, women’s health, pediatric, and geriatric.
- Performs comprehensive evaluations including history and physical exams for gaps in care and preventive assessments.
- Addresses both chronic and acute primary care complaints, and demonstrates ability to ascertain medical urgency.
- Establishes and documents reasonable medical diagnoses.
- Seeks specialty consultation as appropriate.
- Orders/performs pertinent diagnostic laboratory and radiology testing for the medical diagnosis or presenting symptoms; works within an environment of limited resources and therefore uses diagnostic tests judiciously and appropriately.
- Understands when a member's needs are beyond their scope of knowledge and when physician oversight is needed.
- Creates and implements a medical plan of care.
- Schedules appointments for visits when appropriate.
- Provides post-discharge coordination to reduce hospital readmission rates and emergency room utilization.
- Performs face-to-face in-person visits in a variety of settings including in-home, skilled nursing facilities, and public locations.
- Performs face-to-face visits via alternative modalities based on business need, leadership direction and state regulations.
- Orders bulk laboratory orders to target specific member populations.
- Performs alternating on-call coverage to triage any urgent lab results and pharmacy inquiries and develops appropriate plans of care.
- Participates in community-based “pop up clinics” to build relationships with communities, and address gaps in health care.
- Drives up to 120 miles a day on a regular basis to a variety of locations within the assigned region. Drives beyond 120 miles as part of extended mileage may be required on special project days. Special projects may include an overnight hotel stay.
- Obtains and maintains cross-state license in other states besides home state based on business need.
- Collaborates with fellow nurse practitioners to develop best practices to perform work duties efficiently and effectively.
- Actively participates in regional meetings.
- May prescribe medications and perform procedures as appropriate.
- Performs timely medical records documentation in electronic medical record (EMR) computer system.
- On occasion, may be required to walk flights of stairs while carrying up to 50 lbs. of equipment.
- Engages in practices constituting the practice of medicine in collaboration with and under the medical direction and supervision of a licensed physician to the degree required by state laws.
- Local travel required (based upon state/contractual requirements).

REQUIRED QUALIFICATIONS

- At least 1 year of experience as a nurse practitioner, or equivalent combination of relevant education and experience.
- Active and unrestricted national certification from one of the following organizations: American Academy of Nurse Practitioners (AANP) or American Nurses Credentialing Center (ANCC).
- Current state-issued license to practice as a Family Nurse Practitioner (FNP). License must be active and unrestricted in state of practice.
- Prescriber Drug Enforcement Agency (DEA) license with authority to prescribe per state qualifications. License must be active and unrestricted in state of practice.
- Current Basic Life Support (BLS) certification.
- Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements.
- 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 demonstrate self-motivation.
- Responsive in all forms of communication.
- Ability to remain calm in high-pressure situations.
- Ability to develop and maintain professional relationships.
- Excellent time-management and prioritization skills; 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(s) proficiency, and electronic medical record (EMR) experience.

PREFERRED QUALIFICATIONS

- Experience as a registered nurse or nurse practitioner in a home health, community health or public health setting.
- Experience in home health as a licensed clinician, especially in management of chronic conditions.
- Experience with underserved populations facing socioeconomic barriers to health care.
- Immunization and point of care testing skills.
- Bilingual.

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.