RN Care Manager — Care Coordination & Outcomes

Molina Healthcare; Peru (IL); On-site; USD 44,000 - 74,000; Full time

Job summary

Molina Healthcare is seeking an RN Care Manager to support care management and LTSS activities, collaborating with a multidisciplinary team to ensure high-need members progress toward desired outcomes. You will coordinate care across settings, including home visits, with focus on integrating behavioral health and LTSS services.

The role requires extensive communication, strong organizational skills, and willingness to travel 25%–40% locally to meet state contract requirements while maintaining

Qualifications

• At least 2 years of experience in health care, including at least 1 year in care management and LTSS.
• Registered Nurse (RN) with active license in state of practice.
• In some states, a bachelor's degree in a health care related field may be required.
• Valid and unrestricted driver's license with reliable transportation for job-related travel.
• Ability to operate proactively, with attention to detail and strong communication.
• Experience working with diverse populations and coordination across care teams.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates waiver enrollment/disenrollment processes.
• Develops and implements care plans with members and care network to address needs and goals.
• Monitors care plans, documents interventions, and suggests changes as needed.
• Promotes integration of LTSS and behavioral health services to ensure continuity of care.
• Assesses medical necessity, authorizes waiver services, and evaluates funding sources.
• Facilitates ICT meetings for service approvals and collaborates with care teams.
• Uses motivational interviewing and Molina guidelines to support behavior change.
• Assesses barriers to care and provides coordination to address psycho-social, financial, and medical challenges.
• Identifies critical incidents and develops prevention plans for member safety.
• May provide consultation to peers; some cases may involve complex regimens.

Skills

Care management

RN license

Driver's license

Communication

Time management

Problem solving

Self-motivation

Education

Bachelor's degree in health care field

Tools

Microsoft Office

Job description

Molina Healthcare is seeking an RN Care Manager to support care management and LTSS activities, collaborating with a multidisciplinary team to ensure high-need members progress toward desired outcomes. You will coordinate care across settings, including home visits, with focus on integrating behavioral health and LTSS services.

The role requires extensive communication, strong organizational skills, and willingness to travel 25%–40% locally to meet state contract requirements while maintaining