Remote RN Care Manager – LTSS & Care Coordination

Molina Healthcare; Janesville (WI); Remote; USD 36,000 - 71,000; Full time

Job summary

Molina Healthcare seeks a registered nurse to coordinate care management and LTSS for high-need members. Travel within coverage area required to conduct home visits and collaborate with an interdisciplinary team.

The role focuses on comprehensive assessments, care plan development, and ongoing monitoring to ensure quality and cost-effective care. Strong communication and organization are essential.

Qualifications

• RN licensure active and unrestricted in state of practice.
• Bachelor's degree requirement may be state dependent.
• Experience in care management, managed care, LTSS, or equivalent.
• Driver's license and reliable transportation for travel requirements.
• Ability to work independently and manage multiple priorities.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians and care team.
• Monitors care plans for effectiveness and documents progress.
• Promotes integration of services across LTSS, behavioral health, and community resources.
• Assesses medical necessity and authorizes waiver services.
• Evaluates covered benefits and funding sources.
• Facilitates ICT meetings for service decisions.

Skills

RN

Driver's license

Communication skills

Microsoft Office

Time management

Problem solving

Independent work

Self-motivation

Diversity awareness

Education

Bachelor's degree in health care

Certified Case Manager (CCM)

Tools

Microsoft Office

Job description

Molina Healthcare seeks a registered nurse to coordinate care management and LTSS for high-need members. Travel within coverage area required to conduct home visits and collaborate with an interdisciplinary team.

The role focuses on comprehensive assessments, care plan development, and ongoing monitoring to ensure quality and cost-effective care. Strong communication and organization are essential.