Care Manager, LTSS (RN) - Vermillion, Iroquios, Coles

IntelliResume; California (MO); On-site; USD 37,000 - 74,000; Full time

Job summary

Molina Healthcare is seeking a Care Manager (RN) to coordinate LTSS for high-need members. The role collaborates with a multidisciplinary team to ensure quality, cost-effective care and seamless service delivery.

Responsibilities include comprehensive assessments, waiver enrollment, care plan development, monitoring outcomes, and coordinating with behavioral health and community resources. Requires an active RN license and relevant LTSS experience.

Qualifications

• RN License must be active and unrestricted in state of practice.
• Bachelor's degree in a health care related field may be required in some states.
• CCM certification preferred.

Responsibilities

• Complete comprehensive member assessments within 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 authorize 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.
• Conduct medication reconciliation as needed.

Skills

Care management

Motivational interviewing

Care coordination

Behavioral health coordination

Education

RN license

Bachelor's degree in healthcare

Tools

CCM (Certified Case Manager)

Job description

About This Role

The Care Manager (RN) for Long-Term Services and Supports (LTSS) will provide support for care management and coordination activities, collaborating with a multidisciplinary team to ensure quality and cost-effective member care for individuals with high-need potential.

Highlights

• Pay: $27 - $54/hour
• Location: Gilman, 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 authorize 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.
• 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 (LTSS).

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 healthcare services to individuals and families, ensuring access to necessary resources and support.