RN Care Navigator: LTSS & Waiver Services

Molina Healthcare; Caledonia Township (IL); On-site; USD 39,000 - 74,000; Full time

Benefits offered by this job

Competitive benefits

EOE M/F/D/V

Job summary

Molina Healthcare is expanding its care management team to support members requiring long-term services and supports. The role emphasizes care coordination across a multidisciplinary team to improve outcomes while containing costs. Travel to member sites will be required to conduct home visits and assessments.

The ideal candidate is a licensed RN with related care management experience, strong communication skills, and the ability to operate across diverse settings with minimal supervision.

Qualifications

• Active RN license in state of practice.
• Minimum 2 years in health care including care management or LTSS exposure.
• Experience with persons with disabilities and chronic conditions a plus.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitate waiver enrollment and disenrollment.
• Develop and implement care plans with members, caregivers, physicians and care network.
• Monitor care plan effectiveness and document interventions and goals.
• Promote integration of LTSS and behavioral health services for continuity of care.
• Assess medical necessity and authorize waiver services.
• Facilitate ICT meetings for approvals/denials; educate and motivate members.
• Travel 25–40% locally as required by state/contractual need.

Education

Registered Nurse (RN) license

Bachelor’s degree in healthcare-related field (optional, depending on state requirements)

Job description

Molina Healthcare is expanding its care management team to support members requiring long-term services and supports. The role emphasizes care coordination across a multidisciplinary team to improve outcomes while containing costs. Travel to member sites will be required to conduct home visits and assessments.

The ideal candidate is a licensed RN with related care management experience, strong communication skills, and the ability to operate across diverse settings with minimal supervision.