Case Manager, LTSS (RN) - field travel in La Crosse County, WI

$49,421 - $107,099/Yr

Molina Healthcare - La Crosse, WI

Full-time - Mid Level

La Crosse, WI

251-500 employees

Insurance Carriers and Related Activities

About the position

As a Case Manager at Molina Healthcare, you will collaborate with members, providers, and a multidisciplinary team to assess, facilitate, plan, and coordinate integrated care delivery for members with high needs. This role emphasizes behavioral health and long-term care, ensuring that patients receive quality, medically appropriate, and cost-effective care across the continuum.

Responsibilities

• Complete face-to-face comprehensive assessments of members per regulated timelines.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement a case management plan in collaboration with the member, caregiver, physician, and other healthcare professionals.
• Perform ongoing monitoring of the care plan to evaluate effectiveness and suggest changes as needed.
• Promote integration of services for members, including behavioral health care and long-term services and supports.
• Assess for medical necessity and authorize appropriate waiver services.
• Evaluate covered benefits and advise on funding sources.
• Conduct face-to-face or home visits as required.
• Facilitate interdisciplinary care team meetings for service approval or denial.
• Use motivational interviewing to educate and support members during contacts.
• Assess for barriers to care and provide coordination to address obstacles.
• Identify critical incidents and develop prevention plans for member health and welfare.
• Provide consultation and recommendations to non-RN case managers.
• Work with members who have complex medical conditions and medication regimens.
• Conduct medication reconciliation when needed.

Requirements

• 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 in case management, disease management, managed care, or medical/behavioral health settings.
• Active, unrestricted State Registered Nursing license (RN) in good standing.
• Valid driver's license with a good driving record for field work.

Nice-to-haves

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

Benefits

• Medical, Dental, and Vision Insurance
• Group & Voluntary Life Insurance
• Aflac, Pet Health, and Identity Theft Insurance
• Flexible Spending Accounts
• 401K and Roth 401K
• Employee Stock Purchase Plan
• Continuing Education Units
• Education Reimbursement
• Paid Time Off
• Volunteer Time Off
• Company Holidays
• Legal Assistance Plan
• Employee Assistance & Well Being Programs
• Employee Perks Platform
• Rideshare Portal