RN Care Manager - LTSS & Waiver Services

Molina Healthcare; Town of Columbus (WI); On-site; USD 36,000 - 70,000; Full time

Job summary

Molina Healthcare seeks a registered nurse care manager to coordinate long-term services and supports, collaborating with an interdisciplinary team to deliver integrated member care. You will assess, plan, monitor, and advocate to ensure quality outcomes while managing waiver services and caregiver collaboration.

Travel is expected (25–40%), and the role emphasizes behavioral health integration and resource coordination across care settings.

Qualifications

• RN license active and unrestricted in state of practice.
• 2+ years in health care with care management or LTSS experience.
• Valid driver's license and reliable transportation.

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, caregivers, physicians and other professionals to address needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness and document interventions.
• Promotes integration of services for members including behavioral health care and LTSS and home/community resources.
• Assesses medical necessity and authorizes waiver services.
• Evaluates covered benefits and advises regarding funding sources.
• Facilitates ICT meetings for approval/denial of services and collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate and support change.
• Assesses barriers to care and provides coordination to address psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans for member health and welfare.
• Care manager RNs may handle complex cases and medication regimens.

Skills

Communication

Time management

Problem solving

Self-motivation

Interpersonal skills

Documentation

Education

Registered Nurse (RN) license

Tools

Microsoft Office

Job description

Molina Healthcare seeks a registered nurse care manager to coordinate long-term services and supports, collaborating with an interdisciplinary team to deliver integrated member care. You will assess, plan, monitor, and advocate to ensure quality outcomes while managing waiver services and caregiver collaboration.

Travel is expected (25–40%), and the role emphasizes behavioral health integration and resource coordination across care settings.