RN Care Manager — LTSS & Care Coordination

Molina Healthcare; Sycamore (IL); On-site; USD 37,000 - 74,000; Full time

Job summary

Molina Healthcare is seeking a registered nurse to provide care management and coordination for members needing LTSS. The role involves collaborating with a multidisciplinary team to ensure high-quality, cost-effective care.

You will assess, plan, and monitor member care, coordinate waiver services, and promote integrated care across behavioral health and LTSS. Travel to various sites may be required.

Qualifications

• Active RN license in state of practice.
• 2+ years healthcare experience with 1+ year in care management.
• Experience with persons with disabilities, chronic conditions, LTSS.
• Valid driver license and reliable transportation.
• Proficiency in 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 others.
• Monitor care plans and evaluate interventions and outcomes.
• Promote integration of LTSS and behavioral health services for continuity of care.
• Assess medical necessity and authorize waiver services.
• Evaluate covered benefits and funding sources.
• Lead ICT meetings for approval/ denial of services.
• Educate and motivate change using motivational interviewing.
• Travel 25-40% as required.

Skills

RN license

Care management

Disabilities/LTSS experience

Communication skills

Driver's license

Education

RN licensure

Bachelor's degree in health care field (where required)

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a registered nurse to provide care management and coordination for members needing LTSS. The role involves collaborating with a multidisciplinary team to ensure high-quality, cost-effective care.

You will assess, plan, and monitor member care, coordinate waiver services, and promote integrated care across behavioral health and LTSS. Travel to various sites may be required.