Remote Member Health Assessor – Certified Nursing & Case Management Professional for High‑Need Care Coordination (WI Residents)

Why Join Molina Healthcare Services?

At Molina Healthcare Services (HCS), we are on a mission to transform the health experience for millions of members across the United States. As a leading managed‑care organization, we combine innovative technology, evidence‑based clinical practices, and a compassionate, member‑first philosophy to deliver integrated, cost‑effective care for individuals with complex health needs. Our culture celebrates diversity, encourages continuous learning, and empowers every team member to make a meaningful impact on the lives of the people we serve.

Working with Molina means you become part of a collaborative ecosystem that includes physicians, nurses, social workers, behavioral health specialists, and community partners—all dedicated to helping members achieve optimal health outcomes. If you thrive in a dynamic, remote environment where empathy meets analytics, this is the place where your expertise will shine.

Position Overview – Remote Member Health Assessor

The Remote Member Health Assessor plays a pivotal role in the multidisciplinary care team by conducting comprehensive health risk appraisals, developing personalized care plans, and guiding members toward self‑management and wellness. Reporting to the HCS Clinical Coordinator, you will leverage cutting‑edge web‑based platforms to document assessments, provide telephonic education, and ensure that every interaction aligns with Molina’s high standards of quality, safety, and cost‑efficiency.

Key Responsibilities

• Member Engagement & Assessment: Initiate contact with assigned members, conduct standardized Health Risk Appraisals (HRA), verify medical histories, and capture current wellness needs.
• Care Planning & Coordination: Develop individualized problem lists and evidence‑based care plans using program protocols, incorporating member preferences and social determinants of health.
• Collaborative Decision‑Making: Partner with registered nurses (RNs), licensed clinical social workers, and other specialists to obtain input on complex cases and adjust plans accordingly.
• Telephonic Education: Deliver clear, culturally sensitive education on disease management, medication adherence, lifestyle modification, and self‑care techniques across chronic conditions such as diabetes, hypertension, COPD, and mental health disorders.
• Documentation & Data Integrity: Accurately record all assessments, interventions, and outcomes in Molina’s secure, web‑based case management system, ensuring compliance with HIPAA and regulatory standards.
• Performance Metrics & Reporting: Meet or exceed daily outreach targets, quality benchmarks, and documentation timeliness metrics; provide regular updates to supervisors and participate in performance reviews.
• Community and Resource Linkage: Identify and refer members to community resources, support groups, and ancillary services that address gaps in care, transportation, nutrition, and social support.
• Travel (Minimal): Participate in occasional local outreach events or in‑person meetings (5‑15% of time) as needed to strengthen relationships with providers and community partners.

Essential Qualifications

• Education: Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) program or a Bachelor’s/Master’s degree in Social Science, Psychology, Gerontology, Public Health, or Social Work.
• Experience: 1‑3 years of direct experience in case management, disease management, managed care, or medical/behavioral health settings, demonstrating a solid grasp of care coordination principles.
• Licensure & Certification: Active, unrestricted nursing license (if applicable) in good standing, or relevant professional certification (e.g., LCSW, CCM, CHEP). Must also possess a valid driver’s license with a clean driving record for occasional local travel.
• Technical Proficiency: Comfortable navigating web‑based electronic health record (EHR) and case management platforms, conducting telephonic outreach, and documenting interactions with precision.
• Communication Skills: Exceptional verbal and written communication abilities, with a talent for explaining complex medical concepts in plain language.
• Interpersonal Skills: Strong empathy, active listening, and cultural competence to engage diverse member populations effectively.

Preferred Qualifications & Certifications

• 3‑5 years of experience in high‑complexity case management or disease management roles.
• Advanced certifications such as Licensed Clinical Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC/LPCC), Respiratory Therapist, or Licensed Marriage and Family Therapist (LMFT).
• Experience with behavioral health integration, long‑term care coordination, and utilization review processes.
• Demonstrated success in meeting or exceeding productivity and quality metrics in a remote work environment.

Core Skills & Competencies for Success

• Analytical Thinking: Ability to interpret health data, assess risk factors, and develop actionable care strategies.
• Problem‑Solving: Proactive approach to identifying barriers to care and implementing creative solutions.
• Time Management: Efficiently prioritize a high volume of member contacts while maintaining accuracy and compliance.
• Collaboration: Work seamlessly with multidisciplinary teams, respecting each professional’s expertise.
• Technology Savvy: Quick adaptation to new software tools, virtual meeting platforms, and data analytics dashboards.
• Regulatory Knowledge: Familiarity with Medicare/Medicaid regulations, HIPAA privacy standards, and industry best practices.

Career Growth & Learning Opportunities

Molina Healthcare invests heavily in the professional development of its workforce. As a Remote Member Health Assessor, you will have access to:

• Continuing Education: Tuition reimbursement for relevant coursework, certifications, and graduate degrees.
• Mentorship Programs: Pairing with seasoned clinical leaders to accelerate skill acquisition and leadership readiness.
• Internal Mobility: Pathways to advance into senior case management, clinical supervisory, or specialty health coach roles.
• Leadership Development: Opportunities to lead quality improvement projects, pilot innovative care models, and present findings to executive stakeholders.
• Professional Networks: Participation in national conferences, webinars, and industry forums funded by Molina.

Work Environment & Company Culture

Our remote team thrives on flexibility, autonomy, and a supportive atmosphere. While you will work from the comfort of your home, you will remain deeply connected to a vibrant community of colleagues through:

• Virtual Collaboration: Regular video huddles, case reviews, and peer‑learning sessions to foster teamwork.
• Well‑Being Initiatives: Access to employee assistance programs, mental health resources, and wellness challenges.
• Diversity, Equity & Inclusion: Commitment to building an inclusive workplace where every voice is valued.
• Recognition Programs: Employee of the month, performance bonuses, and peer‑nominated awards celebrating excellence.

Compensation, Benefits & Perks

While exact compensation varies by geography, experience, and education, qualified candidates can expect a competitive hourly wage ranging from $21.82 to $42.55, complemented by a comprehensive benefits package that includes:

• Medical, dental, and vision insurance with multiple plan options.
• Retirement savings plan with company matching contributions.
• Paid time off, holidays, and sick leave to support work‑life balance.
• Flexible scheduling to accommodate personal commitments.
• Technology stipend for home‑office equipment and high‑speed internet.
• Professional liability coverage and access to legal resources.
• Employee discount programs and wellness rewards.

How to Apply

If you are passionate about empowering members to achieve better health outcomes, possess the required qualifications, and thrive in a remote, collaborative environment, we encourage you to apply today. Click the link below to submit your resume, cover letter, and any relevant certifications.

Take the next step in your career—join Molina Healthcare Services and make a difference, one member at a time.

Apply Now – Remote Member Health Assessor (WI Residents)

Equal Opportunity Employer

Molina Healthcare is proud to be an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees, applicants, and members, regardless of race, color, religion, gender, sexual orientation, gender identity, national origin, veteran status, or disability status.