RN Care Manager — LTSS Care Coordination & Outcomes

Molina Healthcare, Inc.; Capron (IL); Hybrid; USD 38,000 - 74,000; Full time

Job summary

Molina Healthcare is seeking a qualified Care Manager RN to support LTSS care coordination and care management activities. You will collaborate with a multidisciplinary team to coordinate member care across the continuum and ensure progress toward outcomes while contributing to cost-effective, quality member care.

The role involves comprehensive member assessments, waiver enrollment coordination, care plan development, monitoring, and service coordination across behavioral health and LTSS.

Qualifications

• 2+ years in health care with care management or managed care experience.
• RN license active and unrestricted in state of practice; may need BS in some states.
• Strong communication, organization, and ability to work independently.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including home visits when required.
• Coordinate waiver enrollment/disenrollment and develop care plans with stakeholders.
• Monitor care plans, document interventions and adjust as needed.
• Promote integrated services across behavioral health, LTSS, and community resources.
• Assess medical necessity and authorize applicable waiver services.
• Facilitate ICT meetings for service approvals/denials and coordinate referrals.

Skills

Health care experience

Care management

RN (active license)

Driver's license

Strong communication

Time management

Education

Registered Nurse (RN) license

Bachelor's degree in health-related field

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a qualified Care Manager RN to support LTSS care coordination and care management activities. You will collaborate with a multidisciplinary team to coordinate member care across the continuum and ensure progress toward outcomes while contributing to cost-effective, quality member care.

The role involves comprehensive member assessments, waiver enrollment coordination, care plan development, monitoring, and service coordination across behavioral health and LTSS.