Join Our Team at My Choice Wisconsin! Job Summary At Molina Healthcare Services, we are dedicated to delivering integrated care to our members with high need potential. Our Care Managers work closely with members, their families, providers, and a multidisciplinary team to assess needs, facilitate services, and coordinate an effective care delivery approach that includes both behavioral health and long-term care. We strive to achieve quality care that is clinically appropriate and cost-effective, ensuring that our members make progress towards their desired health outcomes. Key Responsibilities Conduct face-to-face comprehensive assessments of members within regulated timelines. Guide members through the comprehensive waiver enrollment and disenrollment processes. Collaborate with members, caregivers, and healthcare professionals to develop and implement a personalized case management plan. Monitor care plans continually to assess effectiveness and suggest modifications based on member needs and goals. Enhance continuity of care by integrating services, including behavioral health and long-term services and supports. Assess medical necessity and authorize appropriate waiver services. Advise on covered benefits and potential funding sources. Conduct necessary home visits and face-to-face interactions. Facilitate interdisciplinary care team meetings for service approvals and collaborative discussions. Utilize motivational interviewing techniques to educate and support members during interactions. Identify barriers to care and provide effective care coordination and assistance addressing various challenges. Monitor critical incidents and develop prevention plans to ensure member well-being. Consult and educate non-RN case managers as needed. Manage complex cases with intricate medical conditions and medication plans. Perform medication reconciliation when necessary. This role requires 50-75% travel. Qualifications Required Education Graduate from an Accredited School of Nursing Required Experience Minimum of 1 year of experience supporting individuals with disabilities or chronic conditions and using Long-Term Services & Supports. 1-3 years of experience in case management, disease management, managed care, or settings related to medical or behavioral health. Licensure/Certification Requirements Active, unrestricted State Registered Nursing license (RN) in good standing. A valid driver's license with a good driving record and reliable transportation is required for fieldwork. Preferred Education Bachelor’s Degree in Nursing Preferred Experience 3-5 years in case management, disease management, managed care, or relevant medical or behavioral health settings. 1 year of experience serving populations receiving waiver services. Preferred Certifications Active and unrestricted Certified Case Manager (CCM) If you are passionate about improving lives and want to make a real impact in the community, we encourage you to apply. Molina Healthcare is proud to be an Equal Opportunity Employer (EOE) M/F/D/V. Compensation: $26.41 - $51.49 per hour *Actual compensation may vary based on geographic location, work experience, education, and skills.