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Case Manager, LTSS (RN)
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Job Description We are seeking a
Registered Nurse (RN)
who lives in Illinois and is licensed in the state of Illinois. The Case Manager will work in remote and field settings supporting our Medicaid Population. The role involves physically visiting members’ homes for Face-to-Face assessments, participating in interdisciplinary care team meetings, and ensuring care plans are tailored to members’ health needs. Members require assessments every six months and additional 'trigger assessments' after hospitalizations. Strong computer skills and attention to detail are essential for multitasking across systems, communicating with members, and maintaining accurate notes. This is a fast-paced position where productivity is key.
Travel (50% or more) in the field to member homes in surrounding areas is required. The candidate will primarily work remotely in the Peoria Area with a home office and high-speed internet connectivity. The schedule is Monday through Friday, 8:00 AM to 5:00 PM, with no weekends or holidays.
Job Summary Molina Healthcare Services (HCS) collaborates with members, providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate comprehensive care, including behavioral health and long-term services, for high-need members. The goal is to ensure quality, medically appropriate, and cost-effective care aligned with patient outcomes.
Knowledge/Skills/Abilities
Complete comprehensive face-to-face assessments within regulated timelines.
Facilitate waiver enrollment/disenrollment processes.
Develop and implement case management and waiver service plans in collaboration with members and healthcare professionals.
Monitor care plans for effectiveness and update as needed.
Promote integrated services, including behavioral health and long-term supports.
Assess medical necessity and authorize waiver services.
Evaluate benefits and advise on funding sources.
Conduct face-to-face or home visits as required.
Facilitate interdisciplinary team meetings for service approval or denial.
Use motivational interviewing and clinical guideposts to support members.
Identify barriers to care and assist members in overcoming psycho/social, financial, and medical obstacles.
Develop prevention plans for critical incidents.
Provide consultation and education to non-RN case managers.
Manage cases with complex medical conditions and medication regimens.
Conduct medication reconciliation when needed.
Job Qualifications Required Education Graduate from an accredited School of Nursing.
Required Experience
At least 1 year working with persons with disabilities or chronic conditions and long-term services/supports.
1-3 years in case management, disease management, managed care, or behavioral health settings.
Active, unrestricted State RN license in Illinois.
If field work is required, valid driver’s license, good driving record, and reliable transportation.
State-Specific Requirements Virginia: At least one year of experience working directly with individuals with Substance Use Disorders.
Preferred Education Bachelor’s Degree in Nursing.
Preferred Experience
3-5 years in case management or related fields.
Experience with waiver services preferred.
Preferred License, Certification, and Association Active and unrestricted Certified Case Manager (CCM).
To apply, current Molina employees should use the intranet job listing. Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer (EOE) M/F/D/V.
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Case Manager, LTSS (RN)
role at
ClickJobs.io
Get AI-powered advice on this job and more exclusive features.
Job Description We are seeking a
Registered Nurse (RN)
who lives in Illinois and is licensed in the state of Illinois. The Case Manager will work in remote and field settings supporting our Medicaid Population. The role involves physically visiting members’ homes for Face-to-Face assessments, participating in interdisciplinary care team meetings, and ensuring care plans are tailored to members’ health needs. Members require assessments every six months and additional 'trigger assessments' after hospitalizations. Strong computer skills and attention to detail are essential for multitasking across systems, communicating with members, and maintaining accurate notes. This is a fast-paced position where productivity is key.
Travel (50% or more) in the field to member homes in surrounding areas is required. The candidate will primarily work remotely in the Peoria Area with a home office and high-speed internet connectivity. The schedule is Monday through Friday, 8:00 AM to 5:00 PM, with no weekends or holidays.
Job Summary Molina Healthcare Services (HCS) collaborates with members, providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate comprehensive care, including behavioral health and long-term services, for high-need members. The goal is to ensure quality, medically appropriate, and cost-effective care aligned with patient outcomes.
Knowledge/Skills/Abilities
Complete comprehensive face-to-face assessments within regulated timelines.
Facilitate waiver enrollment/disenrollment processes.
Develop and implement case management and waiver service plans in collaboration with members and healthcare professionals.
Monitor care plans for effectiveness and update as needed.
Promote integrated services, including behavioral health and long-term supports.
Assess medical necessity and authorize waiver services.
Evaluate benefits and advise on funding sources.
Conduct face-to-face or home visits as required.
Facilitate interdisciplinary team meetings for service approval or denial.
Use motivational interviewing and clinical guideposts to support members.
Identify barriers to care and assist members in overcoming psycho/social, financial, and medical obstacles.
Develop prevention plans for critical incidents.
Provide consultation and education to non-RN case managers.
Manage cases with complex medical conditions and medication regimens.
Conduct medication reconciliation when needed.
Job Qualifications Required Education Graduate from an accredited School of Nursing.
Required Experience
At least 1 year working with persons with disabilities or chronic conditions and long-term services/supports.
1-3 years in case management, disease management, managed care, or behavioral health settings.
Active, unrestricted State RN license in Illinois.
If field work is required, valid driver’s license, good driving record, and reliable transportation.
State-Specific Requirements Virginia: At least one year of experience working directly with individuals with Substance Use Disorders.
Preferred Education Bachelor’s Degree in Nursing.
Preferred Experience
3-5 years in case management or related fields.
Experience with waiver services preferred.
Preferred License, Certification, and Association Active and unrestricted Certified Case Manager (CCM).
To apply, current Molina employees should use the intranet job listing. Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer (EOE) M/F/D/V.
#J-18808-Ljbffr