RN Care Manager: Integrated LTSS & Care Planning

Molina Healthcare; Sheboygan (WI); On-site; USD 3,638,000 - 7,093,000; Full time

Job summary

Molina Healthcare in Wisconsin is seeking a qualified Care Manager RN to support care coordination for high-need members across LTSS and behavioral health services. You will collaborate with an interdisciplinary team to assess needs, develop and monitor care plans, and ensure timely waiver enrollment and service delivery.

The role requires strong communication, independent work, and travel up to 40% to member homes and facilities. Active RN license and relevant LTSS experience are essential.

Qualifications

• Minimum 2 years in health care, with at least 1 year in care management/managed care/LTSS exposure.
• RN license active and unrestricted in state of practice.
• In some states, a bachelor’s degree in a health care related field may be required.
• Valid driver’s license and reliable transportation for travel.
• Ability to work independently with strong attention to detail.
• Proficiency with Microsoft Office.

Responsibilities

• Complete comprehensive member assessments within regulated timelines.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians and health professionals.
• Monitor care plan effectiveness and adjust interventions as needed.
• Promote integration of services across behavioral health and LTSS.
• Assess medical necessity and authorize waiver services.
• Coordinate ICT meetings for approval/denial of services.
• Educate and motivate members using motivational interviewing and clinical guidelines.
• Identify barriers to care and address psycho/social, financial, and medical obstacles.
• Travel 25–40% as required by state/contractual needs.

Skills

Communication

Time management

Problem solving

Independence

Travel readiness

Microsoft Office

Education

RN license (active)

Bachelor's degree (health care related)

Tools

Microsoft Office

Job description

Molina Healthcare in Wisconsin is seeking a qualified Care Manager RN to support care coordination for high-need members across LTSS and behavioral health services. You will collaborate with an interdisciplinary team to assess needs, develop and monitor care plans, and ensure timely waiver enrollment and service delivery.

The role requires strong communication, independent work, and travel up to 40% to member homes and facilities. Active RN license and relevant LTSS experience are essential.