RN Care Manager: LTSS & Waiver Care Navigator

Molina Healthcare; Springfield (IL); On-site; USD 39,000 - 74,000; Full time

Job summary

Molina Healthcare is seeking an experienced RN Care Manager to support care management and LTSS coordination across the continuum of member care. You will collaborate with a multidisciplinary team to ensure goals are met and outcomes are achieved.

This role involves comprehensive assessments, waiver processes, care planning, and ongoing monitoring, with travel as required by state/contractual needs. Strong communication and resource coordination are essential.

Qualifications

• 2+ years in health care including care management or LTSS exposure.
• RN license active and unrestricted in state of practice.
• Valid driver's license with reliable transportation for travel.
• Ability to work independently with minimal supervision.
• Knowledge of community resources and ability to connect members.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians and others.
• Monitors care plans and documents interventions and outcomes.
• Promotes integration of LTSS and behavioral health services for continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Facilitates ICT meetings for approvals and collaboration.
• Educates and motivates change using motivational interviewing.
• Assesses barriers to care and provides support for psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans.
• May provide consultation to peers.
• Care managers may handle complex cases and medication reconciliation.
• 25-40% travel may be required.

Skills

Care coordination

RN

Communication

MS Office

Travel readiness

Education

RN License (Active)

BSN preferred

Job description

Molina Healthcare is seeking an experienced RN Care Manager to support care management and LTSS coordination across the continuum of member care. You will collaborate with a multidisciplinary team to ensure goals are met and outcomes are achieved.

This role involves comprehensive assessments, waiver processes, care planning, and ongoing monitoring, with travel as required by state/contractual needs. Strong communication and resource coordination are essential.