Remote RN Care Manager – LTSS & Waiver Services

Molina Healthcare; Aurora (IL); Remote; USD 58,000 - 112,000; Full time

Job summary

Molina Healthcare is seeking a remote field-based Registered Nurse care manager to support care coordination for LTSS in the greater Cook County area. You will collaborate with a multidisciplinary team to ensure integrated delivery of care and progress toward outcomes.

The role requires 2+ years in health care with care management experience, an active RN license, and the ability to travel 25-40% locally. Strong communication, organization, and documentation are essential to deliver

Qualifications

• 2+ years in health care including care management
• RN license active and unrestricted
• Bachelor's degree may be required depending on state
• Valid driver's license and ability to travel 25-40%

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans, including a waiver service plan with members, caregivers, physicians and support network.
• Performs ongoing monitoring of care plan to evaluate effectiveness and suggest changes.
• Promotes integration of services for LTSS and community resources to enhance continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and advises funding sources.
• Facilitates ICT meetings for approval/denial of services.
• Uses motivational interviewing and Molina clinical guideposts to educate and motivate change.
• Assesses barriers to care and provides coordination to address psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans for member health and welfare.
• Care manager RNs may be assigned complex cases and medication reconciliation.
• 25-40% estimated local travel may be required.

Skills

RN license

Care management

Communication skills

Time management

Education

RN license

Bachelor's degree in health care field

CCM certification (preferred)

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a remote field-based Registered Nurse care manager to support care coordination for LTSS in the greater Cook County area. You will collaborate with a multidisciplinary team to ensure integrated delivery of care and progress toward outcomes.

The role requires 2+ years in health care with care management experience, an active RN license, and the ability to travel 25-40% locally. Strong communication, organization, and documentation are essential to deliver