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Job description
About This Role
The Care Manager (RN) for Long-Term Services and Supports (LTSS) is responsible for coordinating care for members with high-need potential, ensuring progress toward desired outcomes, and contributing to quality and cost-effective member care.
Highlights
Pay: $27 - $54/hour
Location: Sycamore, IL
Schedule: Full Time
What You’ll Do
Complete comprehensive member assessments within regulated timelines, including in-person home visits.
Facilitate comprehensive waiver enrollment and disenrollment processes.
Develop and implement care plans in collaboration with members, caregivers, and healthcare professionals.
Perform ongoing monitoring of care plans to evaluate effectiveness and suggest changes.
Promote integration of services for members, including behavioral health care and community resources.
Assess for medical necessity and authorise appropriate waiver services.
Evaluate covered benefits and advise on funding sources.
Facilitate interdisciplinary care team meetings for service approval or denial.
Use motivational interviewing to educate and support members.
Assess for barriers to care and provide coordination to address obstacles.
Identify critical incidents and develop prevention plans for member health and welfare.
Conduct medication reconciliation as needed.
Requirements
Education
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.
Experience
At least 2 years of experience in health care, including 1 year in care management or a medical/behavioral health setting.
Experience working with persons with disabilities, chronic conditions, and long-term services and supports.
Licenses & Certifications
Valid and unrestricted driver's license.
Certified Case Manager (CCM) preferred.
About Molina Healthcare
Molina Healthcare is a leading healthcare provider committed to delivering exceptional patient care. They focus on providing quality health services to individuals and families, ensuring access to necessary care and support.
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Who can apply
Review the original listing for work authorization, qualifications and employer requirements.