RN Care Manager: LTSS & Waiver Coordination

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

Job summary

Molina Healthcare seeks a registered nurse to provide care management and LTSS coordination, collaborating with a multidisciplinary team to ensure quality, cost-effective member care.

The role includes comprehensive assessments, waiver enrollment processes, and care plan development with members and providers, while monitoring outcomes and coordinating across services. Local travel may be required.

Qualifications

• Requires active RN license and eligibility for licensure in the state of practice.
• Bachelor’s degree may be required in some states depending on contractual requirements.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including home visits as required.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians, and others.
• Monitor care plans, document interventions, and adjust as needed.
• Promote integration of services across LTSS and behavioral health to improve continuity of care.
• Assess medical necessity and authorize waiver services; evaluate benefits and funding sources.
• Participate in interdisciplinary care team meetings for service approval or denial.
• Educate and motivate members using motivational interviewing and clinical guidelines.
• Identify barriers to care and assist with psychosocial, financial, and medical issues.

Skills

Care coordination

Home visits

Communication

Time management

Multidisciplinary teamwork

Education

Active RN license (state)

Bachelor’s degree in health care field (optional)

Tools

Microsoft Office

Job description

Molina Healthcare seeks a registered nurse to provide care management and LTSS coordination, collaborating with a multidisciplinary team to ensure quality, cost-effective member care.

The role includes comprehensive assessments, waiver enrollment processes, and care plan development with members and providers, while monitoring outcomes and coordinating across services. Local travel may be required.