RN Care Manager: LTSS & Integrated Care Leader

Molina Healthcare, Inc.; Mount Vernon (IL); On-site; USD 65,000 - 90,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a Care Manager RN to support care coordination for LTSS members. You will collaborate with a multidisciplinary team to deliver integrated care across the continuum, aiming for desired outcomes and cost-effective member care.

The role involves conducting comprehensive assessments, developing care plans, monitoring progress, and coordinating waiver services. Travel of 25-40% may be required based on state contracts and needs.

Qualifications

• 2+ years of experience in health care including 1+ year in care management or managed care and LTSS experience
• RN license active and unrestricted in state of practice
• Bachelor’s degree in health care field may be required in some states
• Valid driver's license with reliable transportation for travel requirements
• Ability to work independently with minimal supervision and manage multiple priorities
• Strong verbal and written communication skills

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans with members and care network to address needs and goals.
• Monitors care plan effectiveness and documents interventions and progress toward goals.
• Promotes integration of services including behavioral health and LTSS to enhance continuity of care.
• Assesses medical necessity and authorizes waiver services; evaluates benefits and funding sources.
• Facilitates ICT meetings for approval/denial of services and collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate and motivate change.
• Identify barriers to care and provide care coordination for psycho-social, financial, and medical obstacles.
• May provide consultation to peers and handle complex member cases; travel may be 25-40%.

Skills

Care management

Communication

Time management

Problem solving

Independence

Interpersonal skills

Diversity awareness

Education

RN license

Bachelor’s degree in health care

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. is seeking a Care Manager RN to support care coordination for LTSS members. You will collaborate with a multidisciplinary team to deliver integrated care across the continuum, aiming for desired outcomes and cost-effective member care.

The role involves conducting comprehensive assessments, developing care plans, monitoring progress, and coordinating waiver services. Travel of 25-40% may be required based on state contracts and needs.