RN Care Navigator — LTSS & Waiver Services

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

Benefits offered by this job

Competitive benefits

Equal Opportunity Employer

Job summary

Molina Healthcare in Illinois seeks a registered nurse care manager to support long-term services and supports (LTSS) coordination and care management. The role collaborates with a multidisciplinary team to deliver integrated member care and cost-effective outcomes.

You will complete comprehensive assessments, facilitate waiver processes, develop and monitor care plans, and coordinate with caregivers and physicians to address member needs with 25–40% local travel requirements.

Qualifications

• At least 2 years of healthcare experience with 1 year in care management or LTSS.
• RN license must be active and unrestricted in practice state.
• Proactive, detail-oriented, and able to work independently with minimal supervision.

Responsibilities

• Complete comprehensive member assessments within required timelines, including in-person home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians and the support network.
• Monitor care plan effectiveness and document interventions and outcomes.
• Integrate behavioral health services with LTSS to ensure continuity of care.
• Assess medical necessity and authorize waiver services; evaluate benefits and funding sources.
• Lead ICT meetings for approval/denial of services and coordinate care.
• Use motivational interviewing to educate and motivate members.
• Identify barriers and provide coordination to address psycho/social, financial and medical needs.
• Travel locally 25-40% as required by state/contractual requirements.

Skills

Care management

Healthcare experience

Communication skills

Time management

Independent work

Education

Registered Nurse (RN) license

Tools

Microsoft Office

Job description

Molina Healthcare in Illinois seeks a registered nurse care manager to support long-term services and supports (LTSS) coordination and care management. The role collaborates with a multidisciplinary team to deliver integrated member care and cost-effective outcomes.

You will complete comprehensive assessments, facilitate waiver processes, develop and monitor care plans, and coordinate with caregivers and physicians to address member needs with 25–40% local travel requirements.