Remote RN Care Manager - LTSS & Waiver Services

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

Job summary

Molina Healthcare is seeking a Remote Care Manager (RN) to support care coordination for LTSS across Dane and Jefferson Counties, WI with travel for member visits. You will collaborate with a multidisciplinary team to coordinate integrated member care while ensuring quality outcomes.

Responsibilities include comprehensive assessments, care plans development, waiver processing, and ongoing monitoring. Strong communication, organizational skills, and ability to travel are essential.

Qualifications

• Minimum 2 years in health care, including care management or LTSS.
• Active RN license in state of practice.
• Valid driver's license and reliable transportation for travel requirements.
• Experience with individuals with disabilities, chronic conditions, or substance use disorders preferred.
• Strong communication and organizational skills.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits.
• Coordinate waiver enrollment and disenrollment processes.
• Develop and monitor care plans with members, caregivers, physicians and support network.
• Monitor and adjust care plans based on progress and outcomes.
• Promote integration of LTSS and behavioral health services.
• Assess medical necessity and authorize waiver services.
• Facilitate interdisciplinary care team meetings for approvals/denials.
• Educate and motivate members using motivational interviewing and Molina guides.
• Identify barriers to care and address psycho/social, financial, and medical obstacles.
• Identify critical incidents and develop prevention plans.
• May provide consultation and resources to peers.
• Care managers may handle complex cases and medication reconciliation.
• Travel 25-40% local may be required.

Skills

Verbal communication

Written communication

Time management

Prioritization

Problem solving

Independent work

Interpersonal skills

Adaptability

Education

RN License

Bachelor's degree in health care field

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Remote Care Manager (RN) to support care coordination for LTSS across Dane and Jefferson Counties, WI with travel for member visits. You will collaborate with a multidisciplinary team to coordinate integrated member care while ensuring quality outcomes.

Responsibilities include comprehensive assessments, care plans development, waiver processing, and ongoing monitoring. Strong communication, organizational skills, and ability to travel are essential.