Care Manager RN: LTSS & Waiver Coordination

Molina Healthcare; Poplar Grove (IL); On-site; USD 38,000 - 74,000; Full time

Job summary

Molina Healthcare is seeking a registered nurse care manager to support care management and coordination for members with high-need potential. You will collaborate with a multidisciplinary team to coordinate integrated care across the continuum and help members progress toward outcomes.

Responsibilities include completing comprehensive assessments, developing care plans, facilitating waiver enrollment, monitoring progress, and addressing barriers to care. Travel up to 40% locally may be required.

Qualifications

• Requires 2+ years in health care with at least 1 year in care management or LTSS.
• RN license active and unrestricted in state of practice.
• In some states, a healthcare-related bachelor's degree may be required.
• Valid driver's license with reliable transportation for local travel.
• Ability to work independently with strong communication and problem-solving skills.

Responsibilities

• Complete comprehensive member assessments within timelines, including home visits when required.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, and providers.
• Monitor care plan effectiveness and adjust as needed.
• Promote integration of services across disciplines and community resources.
• Assess medical necessity, authorize waiver services, and evaluate benefits.
• Coordinate interdisciplinary team meetings for care approvals or denials.
• Provide education and support using motivational interviewing and clinical guidelines.
• Identify barriers to care and address psycho/social, financial, and medical obstacles.
• Coordinate medication reconciliation as needed and assist with complex cases.
• Travel locally 25–40% as required by state/contractual requirements.

Skills

RN

Care management

Disabilities & LTSS

Communication skills

Travel readiness

Education

Active RN license

Bachelor's degree in healthcare (may be required)

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a registered nurse care manager to support care management and coordination for members with high-need potential. You will collaborate with a multidisciplinary team to coordinate integrated care across the continuum and help members progress toward outcomes.

Responsibilities include completing comprehensive assessments, developing care plans, facilitating waiver enrollment, monitoring progress, and addressing barriers to care. Travel up to 40% locally may be required.