Care Manager, LTSS (RN) - Field travel in Milwaukee County, WI

apartment Molina Healthcare location_onMilwaukee, WI, US

JOB DESCRIPTION Job Summary

Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• May provide consultation, resources and recommendations to peers as needed.
• Care manager RNs may be assigned complex member cases and medication regimens.
• Care manager RNs may conduct medication reconciliation as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 2 years experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Ability to operate proactively and demonstrate detail-oriented work.
• Demonstrated knowledge of community resources.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations and various personalities and personal situations.
• Ability to work independently, with minimal supervision and demonstrate self-motivation.
• Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
• In some states, must have at least one year of experience working directly with individuals with substance use disorders.

Preferred Qualifications

• Certified Case Manager (CCM).
• Experience working with populations that receive waiver services.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

#PJNurse

#HTF

Pay Range: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Share this job

Related Jobs

Outpatient

Urgent Care

Part-time

Clinic RN - Delafield Urgent Care Clinic - Part Time Every Other Weekend

apartment ProHealth Care location_onDelafield, WI

Clinic RN – Delafield Urgent Care (.5 FTE, PMs) At ProHealth Care’s Delafield Clinic, our Urgent Care team provides immediate care to patients of all ages, treating everything from fevers and earaches to sprains and minor injuries. This is your chance to join a collaborative group that thrives in a fast-paced environment while delivering compassionate, patient-centered care. Schedule This is a part-time role with benefits (0.5 FTE) that offers a consistent and balanced rotation: Week 1 : Sunday 8:00 a.m.–4:00 p.m.; Tuesday–Thursday 4:00–8:00 p.m. Week 2 : Tuesday–Friday 4:00–8:00 p.m.; Saturday 8:00 a.m.–4:00 p.m. This schedule is a great fit for RNs looking for steady hours in the evenings with every other weekend off, leaving mornings and many weekdays free offering work life balance. Why you’ll love working here A supportive, team-oriented culture where your voice is valued The chance to practice a wide scope of nursing skills with patients of all ages Predictable, lifestyle-friendly hours that help you balance work and life Competitive pay and benefits, including health vision and dental plans, PTO, tuition reimbursement, and 401(k) match Be part of a team that’s trusted by the community and supported by the resources of a leading regional health system. Begin your story with ProHealth Care. Job Summary Utilizes the nursing process to deliver appropriate nursing care and procedures in the clinic setting. Performs nursing acts delegated by a physician, physician assistant or nurse practitioner. Oversees and acts as a professional clinical resource for the Medical Assistant/Clinic LPNs and other ancillary professionals. Act as the resource for data gathering and assessment, triage walk-in and call-in patients to the appropriate health care provider. Established protocols and processes will provide a consistent systematic framework for decision-making and positive patient outcomes. Responsibilities • Performs the duties of a R.N. in accordance with the Nursing Code of Ethics, The Nurse Practice Act of the State of Wisconsin and PHCMA Nursing policies. • Provides health care advice to patients and family members utilizing the nursing process and triage protocols, makes nursing decisions and develops a plan of care based on a phone triage assessment and directs patients to the appropriate healthcare provider / facility. • Completes all documentation accurately, timely and efficiently for regulatory compliance and accurate billing. Follows protocol and routes documents to provider as required. Demonstrates skills necessary for proper documentation in the Electronic Health Record. • Administers medications appropriately using the “5 rights” of administration and “2 identifier system” for proper patient verification. • Performs therapeutic treatments and other health screenings as required by the provider or specialty area. • Administers IV’s according protocol • Make sure exam rooms and procedure areas are clean, orderly and meet organizational and regulatory compliance standards. • Assist physician/providers with procedures using sterile techniques. • Collect / obtain blood, urine or other specimens from patients as needed for patient care. • Assist with splinting, casting or orthopedic appliance fitting when applicable to the role. • Responds to urgent and emergency patient care situations as required under RN nursing practice. • Assists in the control and maintenance of clinic medications, supplies and equipment. Report low supplies, expired supplies and necessary equipment repairs to clinic leadership. Records the use of medications maintaining counts and controls. • Facilitate process for outpatient services, emergency department transfers and hospital admission for the patient and document as necessary. • Performs patient teaching and discharge instructions adhering to the documentation and provision of the after visit summary. • Makes follow up calls to patients under the direction of established protocol and as directed by the physician/provider • Reviews test results and responds appropriately to provider, patient and others involved in care • Maintains and provides patient education materials • Monitors patient needs for prescription refills, follows required protocol with physician/provider What You Will Do: The Clinic RN in the Medical Group utilizes the nursing process to deliver appropriate nursing care and procedures in the clinic setting. The Clinic RN performs nursing acts delegated by a physician, physician assistant or nurse practitioner. This individual oversees and acts as a professional clinical resource for the Medical Assistant/Clinic LPNs and other ancillary professionals. Act as the resource for data gathering and assessment, triage walk-in and call-in patients to the appropriate health care provider. What You Will Need: Registered Nurse in the State of Wisconsin Associate’s Degree in Nursing (ADN) Minimum of 2 years of clinical experience in primary care clinic environment or 3-5 years clinical hospital, home care, or community health experience Basic Life Support (BLS) card through the American Heart Associate (AHA), or ability to obtain certification upon hire About Us: ProHealth Care is an equal opportunity employer and is committed to an inclusive work environment and values the perspectives of our people. We maintain a drug-free workplace and perform pre-employment substance abuse testing. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability. *CA #CA #LI

Outpatient

Urgent Care

Part-time

Clinic RN - Delafield Urgent Care Clinic- .5 FTE - PMs

apartment ProHealth Care location_onDelafield, WI

We are hiring - Delafield Urgent Care - Clinic RN Week 1: Sunday 0800-1600; Monday Off; Tuesday 1600-2000; Wednesday 1600-2000; Thursday 1600-2000; Friday Off; Saturday Off Week 2: Sunday Off; Monday Off; Tuesday 1600-2000; Wednesday 1600-2000; Thursday; Friday 1600-2000; Saturday 0800-1600 We invite you to begin your story with ProHealth Medical Group. With 15 clinic and urgent care locations throughout Waukesha County, you can be an integral part of improving the health of our community. Opportunities within ProHealth Medical Group range from family and internal medicine to specialty practices like allergy, cardiology, dermatology, OB/GYN, orthopedics, pediatrics, and podiatry. If you're like us and are passionate about providing exceptional patient care, we'd like to meet you! We Offer: A culture that's warm, welcoming, and vibrant. A team-oriented work environment where opinions are respected and teamwork is valued. Leading-edge technology with opportunities to learn and grow. Highly competitive wages, an outstanding benefits package and resources to help you further your education. Watch this short video to get to know us better, imagine how you can help make a difference, and then #beginyourstory with ProHealth Care. Job Summary Utilizes the nursing process to deliver appropriate nursing care and procedures in the clinic setting. Performs nursing acts delegated by a physician, physician assistant or nurse practitioner. Oversees and acts as a professional clinical resource for the Medical Assistant/Clinic LPNs and other ancillary professionals. Act as the resource for data gathering and assessment, triage walk-in and call-in patients to the appropriate health care provider. Established protocols and processes will provide a consistent systematic framework for decision-making and positive patient outcomes. Responsibilities • Performs the duties of a R.N. in accordance with the Nursing Code of Ethics, The Nurse Practice Act of the State of Wisconsin and PHCMA Nursing policies. • Provides health care advice to patients and family members utilizing the nursing process and triage protocols, makes nursing decisions and develops a plan of care based on a phone triage assessment and directs patients to the appropriate healthcare provider / facility. • Completes all documentation accurately, timely and efficiently for regulatory compliance and accurate billing. Follows protocol and routes documents to provider as required. Demonstrates skills necessary for proper documentation in the Electronic Health Record. • Administers medications appropriately using the “5 rights” of administration and “2 identifier system” for proper patient verification. • Performs therapeutic treatments and other health screenings as required by the provider or specialty area. • Administers IV’s according protocol • Make sure exam rooms and procedure areas are clean, orderly and meet organizational and regulatory compliance standards. • Assist physician/providers with procedures using sterile techniques. • Collect / obtain blood, urine or other specimens from patients as needed for patient care. • Assist with splinting, casting or orthopedic appliance fitting when applicable to the role. • Responds to urgent and emergency patient care situations as required under RN nursing practice. • Assists in the control and maintenance of clinic medications, supplies and equipment. Report low supplies, expired supplies and necessary equipment repairs to clinic leadership. Records the use of medications maintaining counts and controls. • Facilitate process for outpatient services, emergency department transfers and hospital admission for the patient and document as necessary. • Performs patient teaching and discharge instructions adhering to the documentation and provision of the after visit summary. • Makes follow up calls to patients under the direction of established protocol and as directed by the physician/provider • Reviews test results and responds appropriately to provider, patient and others involved in care • Maintains and provides patient education materials • Monitors patient needs for prescription refills, follows required protocol with physician/provider What You Will Do: The Clinic RN in the Medical Group utilizes the nursing process to deliver appropriate nursing care and procedures in the clinic setting. The Clinic RN performs nursing acts delegated by a physician, physician assistant or nurse practitioner. This individual oversees and acts as a professional clinical resource for the Medical Assistant/Clinic LPNs and other ancillary professionals. Act as the resource for data gathering and assessment, triage walk-in and call-in patients to the appropriate health care provider. What You Will Need: Registered Nurse in the State of Wisconsin Associate’s Degree in Nursing (ADN) Minimum of 2 years of clinical experience in primary care clinic environment or 3-5 years clinical hospital, home care, or community health experience Basic Life Support (BLS) card through the American Heart Associate (AHA), or ability to obtain certification upon hire About Us: ProHealth Care is an equal opportunity employer and is committed to an inclusive work environment and values the perspectives of our people. We maintain a drug-free workplace and perform pre-employment substance abuse testing. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability. *CA #CA #LI

Full-time

Registered Nurse

apartment DaVita Kidney Care location_onNorth Lake, WI

Posting Date 11/14/2025 1350 Montreal RoadSuite 200, Tucker, Georgia, 30084, United States of America DaVita is seeking an organized, self-directed RN to manage Peritoneal Dialysis (PD) patients. You’ll educate patients and caregivers in-clinic, enabling them to perform dialysis independently at home. This role blends clinical care, patient education, and case management. Key Responsibilities: Train patients and caregivers on PD procedures and self-care Manage a caseload of PD patients, including assessments and care planning Monitor treatment progress, conduct home visits, and provide on-call support Collaborate with interdisciplinary teams to ensure safe, high-quality outcomes Schedule: Monday–Friday, 8-hour shifts Weekends and holidays off Flexible scheduling to manage your own caseload Requirements: RN license in the state of practice Valid driver’s license, insurance, and reliable transportation ADN required; BSN preferred Basic computer skills (MS Word, Outlook) Preferred Experience: Dialysis (PD, HHD, chronic, or acute) Patient education or teaching background Case management or telehealth experience CNN or CDN certification What We Offer: Medical, dental, vision, and 401(k) match Paid time off and PTO cash-out Mental health and family support (EAP, Headspace, parental leave, etc.) Paid training and ongoing professional development Empower patients to take control of their care. Make a meaningful impact—apply today. #LI-HF1 At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic. This position will be open for a minimum of three days. For location-specific minimum wage details, see the following link: DaVita.jobs/WageRates Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information.

Full-time

Clinical Nurse III (0139)

apartment ProHealth Care location_onMukwonago, WI

Schedule: 2-8 hour shifts 0645-1515 and 2-10 hour shifts 0645-1715 Monday thru Friday Call every 4th weekend and 1-2 overnight call shifts a week We welcome you to join us at the Mukwonago campus in our newly built and growing OR with 4 large operating room suites and 2 minor procedure suites. Specialties served range from General/Vascular, ENT, GYN, Urology, GI and also a rapidly growing Da Vinci Robotic Program. What You Will Do: What You Will Do: The Clinical Nurse is a competent practitioner who integrates theoretical knowledge with clinical experience in the care of patients and families. Care is delivered using a deliberate, systematic approach and practice is guided by increasing awareness of patterns of patient responses in recurrent situations. These nurses demonstrate a mastery of most technical skills and begin to view clinical situations from a patient and family focus as they provide professional nursing care within clinical areas/ campuses as required by staffing matrices. These nurses also supervise and direct delegated nursing acts commensurate with educational preparation and demonstrated abilities of the person supervised. What You Will Need: Associate's Degree in Nursing required. Bachelor’s Degree is preferred National professional certification in clinical specialty. Wisconsin Registered Nurse License Valid American Heart (AHA) Basic Life Support ( BLS) certification. 2 years of hospital-based nursing experience preferred. About Us: ProHealth Care has been the health care leader in Waukesha County and surrounding areas for the past century, providing outstanding care across a full spectrum of services. The people of ProHealth Care strive to continuously improve the health and well-being of the community by combining skill, compassion and innovation. The ProHealth family includes Waukesha Memorial Hospital, Oconomowoc Memorial Hospital, the Rehabilitation Hospital of Wisconsin, ProHealth Medical Group clinics, AngelsGrace Hospice, ProHealth Home Care & Hospice, West Wood Health & Fitness Center and Regency Senior Communities. Learn more at ProHealthCare.org. ProHealth Care is an equal opportunity employer and is committed to an inclusive work environment and values the perspectives of our people. We maintain a drug-free workplace and perform pre-employment substance abuse testing. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

Per Diem

ER Team Technician-Mukwonago Hospital Emergency Department- PRN/ As Needed

apartment ProHealth Care location_onMukwonago, WI

We Are Hiring: ER Team Technician-Mukwonago Hospital Emergency Department- PRN/ As Needed Begin your story with ProHealth Care! Enjoy our video series featuring our own employees sharing why they choose ProHealth Care and what they enjoy about working here. Schedule Details: This pool position must commit to 36 hours in 6 week schedule with 1 weekend day. 1 holiday per year is also required. This is not a seasonal or temporary position. About Us: The Mukwonago Emergency Department is a full service 16 bed unit that sees almost 10,000 patients annually (birth to end of life); ENT, eye, GYN, orthopedics, cardiac, stroke, trauma, and pediatrics. The staff and physicians are committed to providing high quality, compassionate care to the communities we serve. This Position Will Offer You: Engaging and community focused culture Competitive Salaries Opportunity for professional career growth Robust benefits for full-time and regular part-time roles, including Generous PTO; Choices in insurance; HSA; Tuition reimbursement; immediate 401K match; discounted tickets to various entertainment, social, and sporting events What You Will Do: You will provide care to adults, older adults, children, and neonates with emergent medical conditions under the direct supervision of the Registered Nurse. Other responsibilities of our ER Team Technicians: Transport patients to various locations throughout the hospital Obtain vital signs and pulse oximetry readings Perform IV start for fluid therapy Collect and transport specimens Assist in the setup of equipment: arterial lines, chest tubes, nasogastric suction, airway management, capnography, external pacemaker and seizure pads Assist with C-spine immobilization What You Will Need: High School Diploma or equivalent preferred EMT Basic or higher / CNA at the time of hire May have 2 or more years ED or similar experience in place of EMTb certification Previous experience equivalent t EMT basic / CNA Select candidates who meet Nurse Intern II requirements will also ne considered Previous EMT and IV experience preferred *CA About Us: ProHealth Care has been the health care leader in Waukesha County and surrounding areas providing outstanding care across a full spectrum of services. The people of ProHealth Care strive to continuously improve the health and well-being of the community by combining skill, compassion and innovation. ProHealth Care supports a Just Culture, one that encourages an open learning environment and maintaining safe systems. The ProHealth family includes Waukesha Memorial Hospital, Oconomowoc Memorial Hospital, the Rehabilitation Hospital of Wisconsin, ProHealth Medical Group clinics, AngelsGrace Hospice, ProHealth Home Care & Hospice, West Wood Health & Fitness Center and Regency Senior Communities. This spring we will be opening an additional hospital in Mukwonago, offering more job opportunities. Learn more at ProHealthCare.org/Careers. ProHealth Care is an equal opportunity employer and is committed to an inclusive work environment and values the perspectives of our people. We maintain a drug-free workplace and perform pre-employment substance abuse testing. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.