Care Manager, LTSS (RN) - Boone, Dekalb, Kendall/LaSalle

Molina Healthcare; Sycamore (CA); On-site; USD 37,000 - 74,000; Full time

Job summary

Molina Healthcare in Sycamore, IL seeks a Care Manager (RN) for LTSS to coordinate care for high-need members, develop tailored care plans, and ensure progress toward outcomes.

You will collaborate with members, caregivers, and healthcare professionals to coordinate services, monitor plans, and promote integration of behavioral health and community resources. An active RN license is required; CCM is preferred.

Qualifications

• RN license must be active and unrestricted.
• Bachelor's degree in a health care-related field may be required in some states.
• Minimum 2 years of healthcare experience, with 1 year in care management or medical/behavioral health.
• Experience with persons with disabilities, chronic conditions, and LTSS.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement care plans in collaboration with members, caregivers, and healthcare professionals.
• Perform ongoing monitoring of care plans to evaluate effectiveness and suggest changes.
• Promote integration of services for members, including behavioral health care and community resources.
• Assess for medical necessity and authorise appropriate waiver services.
• Evaluate covered benefits and advise on funding sources.
• Facilitate interdisciplinary care team meetings for service approval or denial.
• Use motivational interviewing to educate and support members.
• Assess for barriers to care and provide coordination to address obstacles.
• Identify critical incidents and develop prevention plans for member health and welfare.
• Conduct medication reconciliation as needed.

Skills

Motivational interviewing

Care coordination

Interdisciplinary collaboration

Assessment skills

Education

RN license active

Bachelor's degree in health care field (optional)

Job description

About This Role

The Care Manager (RN) for Long-Term Services and Supports (LTSS) is responsible for coordinating care for members with high-need potential, ensuring progress toward desired outcomes, and contributing to quality and cost-effective member care.

Highlights

• Pay: $27 - $54/hour
• Location: Sycamore, IL
• Schedule: Full Time

What You’ll Do

• Complete comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement care plans in collaboration with members, caregivers, and healthcare professionals.
• Perform ongoing monitoring of care plans to evaluate effectiveness and suggest changes.
• Promote integration of services for members, including behavioral health care and community resources.
• Assess for medical necessity and authorise appropriate waiver services.
• Evaluate covered benefits and advise on funding sources.
• Facilitate interdisciplinary care team meetings for service approval or denial.
• Use motivational interviewing to educate and support members.
• Assess for barriers to care and provide coordination to address obstacles.
• Identify critical incidents and develop prevention plans for member health and welfare.
• Conduct medication reconciliation as needed.

Requirements

Education

• RN License must be active and unrestricted in state of practice.
• In some states, a bachelor's degree in a health care related field may be required.

Experience

• At least 2 years of experience in health care, including 1 year in care management or a medical/behavioral health setting.
• Experience working with persons with disabilities, chronic conditions, and long-term services and supports.

Licenses & Certifications

• Valid and unrestricted driver's license.
• Certified Case Manager (CCM) preferred.

About Molina Healthcare

Molina Healthcare is a leading healthcare provider committed to delivering exceptional patient care. They focus on providing quality health services to individuals and families, ensuring access to necessary care and support.