RN LTSS Care Manager - Waiver & Care Coordination

Molina Healthcare, Inc.; Gillespie (IL); On-site; USD 65,000 - 90,000; Full time

Job summary

Molina Healthcare is seeking a Nurse Care Manager to support LTSS care coordination and case management. You will collaborate with a multidisciplinary team to ensure high-need members receive integrated care across the continuum, including home visits and waiver services as required.

Responsibilities include assessments, care plan development, monitoring outcomes, and facilitating interdisciplinary team meetings, with 25-40% travel as needed.

Qualifications

• Active RN license in the state of practice.
• At least 2 years health care experience; 1 year in care management or LTSS.
• Experience with disabilities, chronic conditions, or substance use disorders.
• Valid driver's license and reliable transportation.
• Strong communication and organizational skills.
• Proactive, detail-oriented, and able to work independently.

Responsibilities

• Complete comprehensive member assessments within timelines, including in-person home visits as required.
• Coordinate waiver enrollment and disenrollment processes.
• Develop and implement care plans including a waiver service plan with members and care network.
• Monitor care plan effectiveness and adjust interventions as needed.
• Promote integration of LTSS with behavioral health and community resources.
• Assess medical necessity and authorize waiver services.
• Facilitate ICT meetings for approval/denial and collaborate with team.

Skills

RN license

Care management

Communication

Microsoft Office

EMR systems

Driver's license

Education

Bachelor's degree in health care field

Nursing degree

Tools

Microsoft Office

EMR systems

Job description

Molina Healthcare is seeking a Nurse Care Manager to support LTSS care coordination and case management. You will collaborate with a multidisciplinary team to ensure high-need members receive integrated care across the continuum, including home visits and waiver services as required.

Responsibilities include assessments, care plan development, monitoring outcomes, and facilitating interdisciplinary team meetings, with 25-40% travel as needed.