Care Manager, Long Term Services and Supports (LTSS) - Registered Nurse (RN) in St. Clair County, Illinois

Transforming Healthcare through Compassionate Care Management

Molina Healthcare Services (HCS) is seeking a dedicated and experienced Registered Nurse (RN) to join our team as a Care Manager, Long Term Services and Supports (LTSS) in St. Clair County, Illinois. As a Care Manager, you will play a vital role in assessing, facilitating, planning, and coordinating integrated care delivery for members with high needs, including those requiring behavioral health and long-term care services.

About Molina Healthcare Services

Molina Healthcare Services is committed to providing high-quality, patient-centered care that addresses the unique needs of our members. Our team works collaboratively with members, providers, and multidisciplinary healthcare professionals to ensure that our members receive comprehensive, coordinated care that improves their overall health and well-being.

Key Responsibilities

• Conduct face-to-face comprehensive assessments of members within regulated timelines to identify their needs and develop effective care plans.
• Facilitate waiver enrollment and disenrollment processes, ensuring seamless transitions for our members.
• Develop and implement personalized case management plans, including waiver service plans, in collaboration with members, caregivers, physicians, and other healthcare professionals.
• Monitor and evaluate the effectiveness of care plans, documenting interventions and goal achievement, and suggesting changes as needed.
• Promote integration of services, including behavioral health care and long-term services and supports, to enhance continuity of care for Molina members.
• Assess medical necessity and authorize waiver services, ensuring that members receive the care they need.
• Conduct face-to-face or home visits as required, building strong relationships with members and their support networks.
• Facilitate interdisciplinary care team meetings to approve or deny services and collaborate with healthcare professionals.
• Utilize motivational interviewing and Molina clinical guideposts to educate, support, and motivate members to achieve their health goals.
• Identify barriers to care and provide care coordination and assistance to address psycho/social, financial, and medical obstacles.
• Develop prevention plans to ensure member health and welfare, addressing critical incidents and concerns.
• Provide consultation, recommendations, and education to non-RN case managers, sharing your expertise and experience.
• Work with members who have complex medical conditions and medication regimens, conducting medication reconciliation when needed.

Essential Qualifications

To be considered for this role, you must meet the following essential qualifications:

• Graduate from an Accredited School of Nursing.
• At least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports.
• 1-3 years of experience in case management, disease management, managed care, or medical or behavioral health settings.
• Active, unrestricted State Registered Nursing license (RN) in good standing.
• Valid driver's license with a good driving record and reliable transportation (if field work is required).

Preferred Qualifications

While not required, the following qualifications are highly preferred:

• Bachelor's Degree in Nursing.
• 3-5 years of experience in case management, disease management, managed care, or medical or behavioral health settings.
• 1 year of experience working with populations who receive waiver services.
• Active and unrestricted Certified Case Manager (CCM) certification.

Skills and Competencies

To succeed in this role, you will need to possess the following skills and competencies:

• Strong clinical knowledge and experience working with complex medical conditions and medication regimens.
• Excellent communication and interpersonal skills, with the ability to build strong relationships with members, caregivers, and healthcare professionals.
• Ability to work independently and as part of a multidisciplinary team.
• Strong analytical and problem-solving skills, with the ability to assess complex situations and develop effective solutions.
• Compassionate and empathetic approach to care management, with a focus on member-centered care.

Career Growth Opportunities and Learning Benefits

At Molina Healthcare Services, we are committed to supporting the ongoing development and growth of our employees. As a Care Manager, you will have opportunities to:

• Develop your skills and expertise in care management, working with complex medical conditions and populations.
• Collaborate with multidisciplinary teams to improve care delivery and outcomes for our members.
• Participate in ongoing training and education, staying up-to-date on best practices and industry developments.
• Advance your career within the organization, taking on new challenges and responsibilities.

Work Environment and Company Culture

Molina Healthcare Services is an Equal Opportunity Employer (EOE) M/F/D/V, committed to creating a diverse and inclusive work environment. Our company culture is built on the following values:

• Compassionate care: We prioritize the needs of our members, providing high-quality, patient-centered care.
• Collaboration: We work together as a team, sharing our expertise and experience to achieve common goals.
• Innovation: We strive to improve care delivery and outcomes, embracing new ideas and approaches.
• Diversity and inclusion: We value diversity and promote inclusion, creating a work environment that is welcoming and supportive.

Compensation and Benefits

Molina Healthcare Services offers a competitive benefits and compensation package, including:

• A salary range of $27.73 - $54.06 per hour, depending on experience and qualifications.
• A comprehensive benefits package, including medical, dental, and vision coverage.
• Opportunities for career advancement and professional growth.
• A dynamic and supportive work environment.

Join Our Team

If you are a compassionate and experienced Registered Nurse looking for a new challenge, we encourage you to apply for this exciting opportunity. As a Care Manager, Long Term Services and Supports (LTSS) at Molina Healthcare Services, you will play a vital role in transforming healthcare through compassionate care management. Apply today to join our team and make a meaningful difference in the lives of our members!