RN LTSS Care Manager — Field Travel & Care Planning

Molina Healthcare, Inc.; Platteville (WI); Sur place; USD 36 000 - 70 000; Plein temps

Résumé du poste

Molina Healthcare seeks a Care Manager (RN) for field travel in Grant, IA, and Green County, WI, to coordinate LTSS and waiver services. You will assess, plan, implement, and monitor comprehensive care for members with complex needs, collaborating with physicians, caregivers, and the care team.

Required are an active RN license and 2+ years in healthcare, including LTSS or managed care. Travel up to 40% and strong communication are essential for success in this role.

Qualifications

• RN license required and active in state of practice.
• Minimum 2 years healthcare experience with 1 year in care management or LTSS.
• Ability to travel 25-40% locally as required.
• Strong communication and coordination with multidisciplinary teams.

Responsabilités

• Completes comprehensive member assessments within regulated timelines and in-person home visits as needed.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians and support network.
• Monitors and documents progress, adjusts care plan as needed.
• Promotes integration of LTSS and behavioral health services for continuity of care.
• Assesses medical necessity and authorizes waiver services.

Connaissances

Communication

Time management

Problem solving

Detail-oriented

Formation

RN license (active)

Outils

Microsoft Office

Description du poste

Care Manager, LTSS (RN) - Field travel in Grant, Iowa, Green County, WI

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Job Description

JOB DESCRIPTION Job Summary

Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• 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, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• May provide consultation, resources and recommendations to peers as needed.
• Care manager RNs may be assigned complex member cases and medication regimens.
• Care manager RNs may conduct medication reconciliation as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 2 years of experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Ability to operate proactively and demonstrate detail-oriented work.
• Demonstrated knowledge of community resources.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations and various personalities and personal situations.
• Ability to work independently, with minimal supervision and demonstrate self-motivation.
• Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Problem-solving skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
• In some states, must have at least one year of experience working directly with individuals with substance use disorders.

Preferred Qualifications

• Certified Case Manager (CCM).
• Experience working with populations that receive waiver services.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Job Info

• Job Identification 2038522
• Job Category Clinical
• Posting Date 07/28/2026, 12:58 PM
• Job Schedule Full time
• Locations Platteville, WI, United States Dodgeville, WI, United States Monroe, WI, United States New Glarus, WI, United States
• Salary Range $26.41 - $51.49 Hourly *Actual compensation may vary based on geographic location, work experience, education and/or skill level