Case Manager, LTSS (RN) ILLINOIS

ClickJobs.io; Germantown Hills (IL); On-site; Full time

Job summary

A leading healthcare provider is seeking a Case Manager (RN) in Illinois to coordinate care for members with high-need potential. The role involves comprehensive assessments, case management, and collaboration with multidisciplinary teams to ensure quality care. Candidates must have an active Illinois RN license and experience in case management or related fields. This full-time position offers competitive benefits and requires travel within the region.

Qualifications

• 1-3 years in case management, disease management, or behavioral health settings.
• Active, unrestricted Illinois RN license required.

Responsibilities

• Conduct comprehensive assessments and develop case management plans.
• Monitor and adjust care plans, facilitating interdisciplinary meetings.
• Travel 50-75% of the time for home visits and consultations.

Skills

Assessment

Care Coordination

Motivational Interviewing

Case Management

Education

Bachelor's Degree in Nursing

Graduate from an accredited School of Nursing

Job description

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• Illinois residents preferred. Must reside and be willing to travel in Shiloh, O'Fallon, Lebanon, and Belleville, IL. Multiple county coverage.

Job Description

Job Summary
Molina Healthcare Services (HCS) collaborates with members, providers, and multidisciplinary team members to assess, facilitate, plan, and coordinate integrated care across the continuum, including behavioral health and long-term care, for members with high-need potential. HCS staff aim to ensure patients progress toward desired outcomes with quality, medically appropriate, and cost-effective care based on illness severity and service site.

Knowledge/Skills/Abilities

• Complete face-to-face comprehensive assessments of members within regulated timelines.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement case management plans, including waiver service plans, in collaboration with members, caregivers, physicians, and other healthcare professionals.
• Monitor care plans regularly to evaluate effectiveness, document interventions, and adjust as needed.
• Promote service integration, including behavioral health and long-term services, to enhance continuity of care.
• Assess medical necessity and authorize waiver services.
• Evaluate benefits and advise on funding sources.
• Conduct face-to-face or home visits as required.
• Facilitate interdisciplinary care team meetings for service approval or denial.
• Use motivational interviewing and Molina clinical guideposts to educate and motivate members.
• Identify barriers to care and assist members in addressing psycho/social, financial, and medical obstacles.
• Develop prevention plans for critical incidents.
• Provide consultation and education to non-RN case managers.
• Manage cases with complex medical conditions and medication regimens.
• Conduct medication reconciliation as needed.
• Travel 50-75% of the time.

Job Qualifications
Required Education
Graduate from an accredited School of Nursing

Required Experience

• At least 1 year working with persons with disabilities/chronic conditions and Long Term Services & Supports.
• 1-3 years in case management, disease management, managed care, or behavioral health settings.
• Active, unrestricted Illinois RN license.
• Valid driver's license with reliable transportation if field work is required.

State Specific Requirements
Must be licensed in Illinois.

Preferred Education
Bachelor's Degree in Nursing

Preferred Experience

• 3-5 years in relevant healthcare settings.
• Experience with waiver services preferred.

Preferred License, Certification, Association
Certified Case Manager (CCM) active and unrestricted.

To apply, current Molina employees should use the intranet job listing. Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $27.73 - $54.06/hour. Actual pay varies based on location, experience, education, and skills.

Additional Information

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Healthcare Provider
• Industries: Human Resources Services

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