RN Care Manager - LTSS & Waiver Coordination

Molina Healthcare; Milwaukee (WI); Hybrid; USD 33,000 - 72,000; Full time

Job summary

Molina Healthcare in Milwaukee, WI is seeking a licensed RN Care Manager to support LTSS care coordination. You will collaborate with a multidisciplinary team to coordinate member care across the continuum, ensuring progress toward outcomes.

The role involves conducting home visits, coordinating waiver services, developing care plans, monitoring effectiveness, and navigating medical necessity and funding. Travel 25-40% may be required; state-specific requirements apply.

Qualifications

• At least 2 years of healthcare experience, including 1 year in care management or LTSS.
• RN license active and unrestricted in state of practice.
• Bachelor's degree in healthcare field may be required in some states.
• Valid driver's license, reliable transportation for travel.
• Ability to work independently with strong communication and self-motivation.
• Proficiency with Microsoft Office and related software.

Responsibilities

• Complete comprehensive member assessments within regulatory timelines, including in-person home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians, and other health professionals.
• Monitor and adjust care plans based on outcomes and barriers to care.
• Coordinate LTSS, behavioral health, and community resources to ensure integrated care.
• Assess medical necessity and authorize appropriate waiver services.
• Participate in ICT meetings and collaborate across disciplines.
• Educate, motivate and support members during contacts using motivational interviewing.
• Identify barriers to care and address psycho/social, financial, and medical obstacles.
• May provide consultation and support to peers; some cases may involve complex regimens.
• Travel 25–40% as required by state/contractual needs.

Skills

RN license

Communication skills

Independent worker

Time management

Microsoft Office

Travel readiness

Education

Registered Nurse (RN)

Bachelor's degree in health care field (state dependent)

Tools

Microsoft Office

Job description

Molina Healthcare in Milwaukee, WI is seeking a licensed RN Care Manager to support LTSS care coordination. You will collaborate with a multidisciplinary team to coordinate member care across the continuum, ensuring progress toward outcomes.

The role involves conducting home visits, coordinating waiver services, developing care plans, monitoring effectiveness, and navigating medical necessity and funding. Travel 25-40% may be required; state-specific requirements apply.