RN Care Navigator for LTSS & Waivers

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

Job summary

Molina Healthcare in Wisconsin seeks a Care Manager RN to support care management and LTSS activities, collaborating with a multidisciplinary team to coordinate member care across the continuum for high-need members.

The role involves completing assessments, coordinating waiver processes, developing and monitoring care plans, and facilitating ICT meetings, with 25-40% local travel required.

Qualifications

• Active RN license in state of practice.
• Experience in care management or LTSS settings.
• Ability to travel 25-40% locally.
• Strong communication and collaboration skills.
• Proficiency with Microsoft Office.

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, including a waiver service plan in collaboration with members and care network.
• Performs ongoing monitoring of care plan to evaluate effectiveness and document interventions.
• Promotes integration of services for LTSS and behavioral health care to enhance continuity of care.
• Assesses for medical necessity and authorizes waiver services.

Skills

Strong communication

Detail-oriented

Time management

Problem solving

Education

Registered Nurse (RN) license

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

Tools

Microsoft Office

Job description

Molina Healthcare in Wisconsin seeks a Care Manager RN to support care management and LTSS activities, collaborating with a multidisciplinary team to coordinate member care across the continuum for high-need members.

The role involves completing assessments, coordinating waiver processes, developing and monitoring care plans, and facilitating ICT meetings, with 25-40% local travel required.