RN Care Manager: LTSS & Waiver Coordination

Jobtome; Caledonia Township (IL); On-site; USD 38,000 - 74,000; Full time

Job summary

Molina Healthcare is seeking a Registered Nurse to provide care management and coordination for LTSS members. The role focuses on comprehensive assessments, waiver enrollment, and collaborative care planning with a multidisciplinary team to achieve desired outcomes.

The position involves monitoring care plans, ensuring medical necessity, and coordinating with providers to address psycho/social and medical barriers. Travel may be required depending on contracts and state needs.

Qualifications

• Requires RN license active and unrestricted in state of practice.
• Bachelor's degree in health care field may be required in some states.

Responsibilities

• Complete comprehensive member assessments within required timelines.
• Facilitate waiver enrollment/disenrollment processes.
• Develop and implement care plans with members, caregivers and professionals.
• Monitor care plan effectiveness and document outcomes.
• Promote integration of LTSS services and community resources.
• Assess medical necessity and authorize waiver services.
• Coordinate interdisciplinary care team meetings for approvals/denials.
• Wear multiple hats including medication reconciliation as needed.
• Travel 25-40% based on state requirements.

Skills

Care coordination

Communication

Time management

Education

RN license

Bachelor's degree in health care field (may be required)

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Registered Nurse to provide care management and coordination for LTSS members. The role focuses on comprehensive assessments, waiver enrollment, and collaborative care planning with a multidisciplinary team to achieve desired outcomes.

The position involves monitoring care plans, ensuring medical necessity, and coordinating with providers to address psycho/social and medical barriers. Travel may be required depending on contracts and state needs.