RN Care Manager – LTSS & Care Coordination

Molina Talent Acquisition; Illinois; On-site; USD 70,000 - 90,000; Full time

Job summary

Molina Healthcare is seeking a Registered Nurse to provide care management and care coordination for members requiring LTSS, across the continuum of care. You will collaborate with the multidisciplinary team to develop, implement, and monitor care plans, ensuring quality and cost-effective outcomes.

Responsibilities include comprehensive assessments, waiver enrollment, service coordination, and travel within the local region. Strong communication and problem-solving skills are essential.

Qualifications

• Active RN license in state of practice.
• Proven ability to work with diverse populations and settings.
• Experience with care management, managed care, LTSS, or related fields.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, and providers.
• Monitors care plan effectiveness and documents interventions.
• Coordinates services across behavioral health and LTSS for continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and funding sources; informs on options.
• Leads ICT meetings for approvals/denials and collaboration.
• Educates and motivates members using motivational interviewing and clinical guides.
• Identifies barriers to care and provides coordination to address psycho/social and medical issues.
• Develops prevention plans for member health and welfare.
• May provide consultations to peers.

Skills

Communication skills

Time management

Problem-solving

Detail-oriented

Self-motivation

Education

Registered Nurse (RN) license

Bachelor's degree in healthcare (states vary)

Tools

Microsoft Office

EHR systems

Job description

Molina Healthcare is seeking a Registered Nurse to provide care management and care coordination for members requiring LTSS, across the continuum of care. You will collaborate with the multidisciplinary team to develop, implement, and monitor care plans, ensuring quality and cost-effective outcomes.

Responsibilities include comprehensive assessments, waiver enrollment, service coordination, and travel within the local region. Strong communication and problem-solving skills are essential.