RN Care Manager - LTSS & Waiver Services

Molina Healthcare; Watertown (WI); On-site; USD 36,000 - 71,000; Full time

Benefits offered by this job

Competitive benefits

EOE

Job summary

Molina Healthcare is seeking a Registered Nurse Care Manager in Wisconsin to support LTSS and care coordination across the continuum. You will conduct comprehensive assessments, develop and monitor care plans, and collaborate with an interdisciplinary team to ensure timely access to services.

Responsibilities include waiver management, coordination of behavioral health and community resources, and navigating barriers to care while traveling as required.

Qualifications

• At least 2 years in health care, including 1 year in care management or LTSS.
• RN license active and unrestricted in state of practice.
• Bachelor's degree in health care field may be required depending on state/contractual needs.
• Valid driver's license and reliable transportation for travel requirements.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitate waiver enrollment/disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians and others.
• Monitor care plans and document interventions and goals achieved.
• Promote integration of LTSS, behavioral health, and community resources.
• Assess medical necessity and authorize waiver services as appropriate.
• Evaluate benefits and advise on funding sources.
• Lead interdisciplinary care team meetings for service decisions.
• Use motivational interviewing and Molina clinical guidelines to educate and motivate.
• Identify barriers to care and provide coordination to address psychosocial, financial, and medical obstacles.
• Identify critical incidents and develop prevention plans.
• Consult with peers as needed and handle complex cases with RNs.
• Travel 25-40% based on state/contract requirements.

Skills

Care coordination

Communication skills

Time management

Microsoft Office

Proactive work style

Education

RN license

Bachelor's degree may be required

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Registered Nurse Care Manager in Wisconsin to support LTSS and care coordination across the continuum. You will conduct comprehensive assessments, develop and monitor care plans, and collaborate with an interdisciplinary team to ensure timely access to services.

Responsibilities include waiver management, coordination of behavioral health and community resources, and navigating barriers to care while traveling as required.