RN Care Manager - LTSS & Care Coordination

Molina Healthcare, Inc.; Vernon (IL); On-site; USD 38,000 - 74,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

Molina Healthcare, Inc. is seeking an RN with care management experience to support LTSS coordination and comprehensive member care. You will collaborate with a multidisciplinary team to ensure quality, cost-effective outcomes across the continuum.

You will conduct comprehensive assessments, facilitate waiver processes, and develop care plans with input from members, caregivers, and clinicians. Travel up to 40% may be required.

Qualifications

• Minimum 2 years in health care with at least 1 year in care management or LTSS.
• 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.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including home visits.
• Coordinate waiver enrollment/disenrollment processes.
• Develop and implement care plans with members, families, and health professionals.
• Monitor care plan effectiveness and document outcomes.
• Promote integration of LTSS with behavioral health services and community resources.
• Assess medical necessity and authorize services as appropriate.
• Facilitate ICT meetings for approval/denial of services.
• Educate and motivate members using motivational interviewing and Molina guidelines.
• Identify barriers to care and coordinate psychosocial, financial, and medical support.
• Identify critical incidents and develop prevention plans.
• May provide consultation to peers as needed.
• Care manager RNs may handle complex cases and medication reconciliation.
• Travel 25-40% may be required.

Skills

Communication skills

Time management

Problem-solving

Self-motivation

Detail-oriented

Calm under pressure

Education

Registered Nurse (RN) license

Bachelor's degree in healthcare field (optional depending on state)

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. is seeking an RN with care management experience to support LTSS coordination and comprehensive member care. You will collaborate with a multidisciplinary team to ensure quality, cost-effective outcomes across the continuum.

You will conduct comprehensive assessments, facilitate waiver processes, and develop care plans with input from members, caregivers, and clinicians. Travel up to 40% may be required.