Remote RN Care Manager for LTSS & Waivers

Molina Healthcare; Illinois; On-site; USD 39,000 - 74,000; Full time

Job summary

Molina Healthcare is seeking a remote field-based RN Care Manager to support LTSS and care coordination in the greater Cook County area, with travel as required. The role collaborates with interdisciplinary teams to deliver integrated member care and to promote outcomes with cost-effective strategies.

The ideal candidate has 2+ years in health care and care management, an active RN license, and a drive to improve access to services while navigating complex needs.

Qualifications

• Active RN license in state of practice.
• At least 2 years in health care, with care management or LTSS focus.
• Valid driver's license and reliable transportation for travel.
• Ability to work independently and manage multiple priorities.
• Strong communication and problem-solving skills.
• Experience with community resources and interdisciplinary teams.
• Experience with substance use disorders is a plus.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and LTSS and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• May provide consultation, resources and recommendations to peers as needed.
• Care manager RNs may be assigned complex member cases and medication regimens.
• Care manager RNs may conduct medication reconciliation as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Skills

RN License

Care Management

Disability experience

Communication

Time Management

Travel Ready

Education

Bachelor’s degree in health care field

CCM certification

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a remote field-based RN Care Manager to support LTSS and care coordination in the greater Cook County area, with travel as required. The role collaborates with interdisciplinary teams to deliver integrated member care and to promote outcomes with cost-effective strategies.

The ideal candidate has 2+ years in health care and care management, an active RN license, and a drive to improve access to services while navigating complex needs.