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

Molina Healthcare Milwaukee, WI, US

Apply Now

$26.41 - $51.49 / hour

Apply Now

JOB DESCRIPTION

Family Care with My Choice Wisconsin

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

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

Full-time

1 month ago

Clinic RN - Waterford Clinic - Primary Care Phone Triage & Nurse Visits

ProHealth Care Waterford, WI

Clinic RN – Days (Primary Care Triage) | Waterford 1.0 FTE Begin your story with ProHealth Medical Group. We are seeking a Clinic RN to join our Waterford primary care team. This full-time, day-shift role offers a consistent weekday schedule and the opportunity to focus on phone triage, nurse visits, and patient education in a collaborative clinic environment. Schedule Monday through Friday, 8:00 a.m. to 4:30 p.m. What you’ll do This role supports primary care patients through clinical phone triage, nurse visits, and care coordination. You’ll work closely with providers and clinic staff to ensure patients receive timely, high-quality care. Responsibilities include • Clinical phone triage and patient assessment • Nurse visits and patient education • Care coordination and follow-up • Collaboration with providers and care teams • Cross-training opportunities in lab services and urgent care support, based on clinic needs If you’re an RN who values predictable hours, meaningful patient interaction, and a supportive ambulatory care setting, we’d love to connect with you. 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.

Urgent Care

Part-time

1 week ago

Registered Nurse (RN) - Urgent Care

Advocate Aurora Health Mukwonago, WI

$35.50 - $53.25 / hour

Department: 02190 AMG Mukwonago - Immediate Care Status: Part time Benefits Eligible: Yes Hou rs Per Week: 20 Schedule Details/Additional Information: Urgent Care hours 8-8 weekdays, Weekends and Holidays 8-4. Rotating shifts. Must be willing to work 3 weekend shifts a month and 1-2 Friday nights. Experience in Emergency or Urgent Care preferred. Pay Range $35.50 - $53.25 Major Responsibilities: Engages in unit councils, professional governance, and quality initiatives to improve care processes and apply evidence-based practices. Utilizes the nursing process to assess, plan, diagnose, implement, and evaluate nursing care, engaging patients and families through the continuum of care. Monitors patient conditions, adjusts care plans, mobilizes resources, and collaborates with the care team to influence care outcomes. Upholds and promotes a culture of safety. Continuously evaluates patient, team, and unit outcomes, taking action as needed. May administer medications, treatments, and therapies safely and according to clinical protocols and procedures. Demonstrates effective communication, feedback, and conflict resolution, fostering team collaboration and appropriate delegation. Pursues professional development, completes required education, and maintains certifications. Adhere to the ANA Code of Ethics and practices ethical decision-making, respects interdisciplinary roles, and contributes to integrated, unbiased patient care. Appropriate delegation to other Registered Nurses, Licensed Practical Nurses, and unlicensed assistive personnel (i.e., nurse aides, credentialed medical assistants, etc.). Maintains accurate, timely EHR documentation. May be required to float to other units, departments, care areas, or facilities within the designated service area to meet patient care needs. Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the department's policies and procedures. Age-specific information is developed further in the departmental job standards. Minimum Job Requirements Education Graduate of a Board of Nursing approved nursing education program. Certification / Registration / License Basic Life Support (BLS). Additional education, training, certifications, or experience may be required based on specialty. Active, unrestricted registered nurse (RN) multi-state compact and/or single-state license with privileges to practice in the state(s) where the RN is providing client nursing services Note : Licensed nurses practicing via telehealth/telenursing/virtual modalities are required to be licensed or hold the privilege to practice in the state(s) where the client(s) is/are located. Licensed nurses are responsible and accountable for knowing, understanding, and practicing in compliance with the laws, rules, regulations, and standards of practice of the state(s) where the client(s) is/are located. Experience Typically requires 1 year of experience in clinical nursing. Knowledge / Skills / Abilities Strong clinical judgment and critical thinking. Time management, prioritization and problem-solving skills. Excellent communication and interpersonal skills. Ability to work in a fast-paced, dynamic environment. Proficiency in operating computer functions (e.g., E-mail, electronic records, digital platforms etc.) clinical, aviation, maintenance, communications, and administrative departments. Physical Requirements and Working Conditions Must be able to sit, stand, walk, lift, squat, bend, reach above shoulders, and twist frequently throughout the workday. Must be able to lift and support the weight of 35 pounds in handling patients, medical equipment, and supplies. Must be able to: push/pull with 30 lbs. of force and perform a sliding transfer of 150 lbs. with a second person present. Must have functional speech, vision, hearing, and touch with ability to use fine hand manipulation skills for IV insertion and other procedures/functions. Maneuver foot pedals on carts or machines. Perform physical safety interventions such as patient restraint and verbal de-escalation, if needed. May be exposed to chemical and hazardous waste as well as blood and body fluids and communicable disease. Therefore, protective clothing and equipment must be worn as necessary. Must be able to respond quickly to changes in patient and/or unit conditions. Physical Abilities Testing may be required. Additional department specific physical requirements may be identified for unique responsibilities within the department by the nurse leader. Preferred Job Requirements Education Bachelor of Science degree in Nursing (BSN) This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

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

ProHealth Care Delafield, 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

Full-time

1 week ago

Registered Nurse (RN) - Family Medicine Clinic

Advocate Aurora Health Racine, WI

$35.50 - $53.25 / hour

Department: 01120 AMG Mount Pleasant Green Bay Road - Family Medicine Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Monday-Friday scheduled hours between 7:00am-5:00pm. Schedule to be determined. Pay Range $35.50 - $53.25 Where You Will Work : Our primary care physicians at Aurora Family Medicine in Mount Pleasant, WI, provide the high-quality, personalized care you deserve. Primary care is the first point of contact in health care and our family medicine physicians are here to care for your entire family. Our address is 6611 Spring St., Mount Pleasant, WI. When you’re looking for primary care close to home, visit us in Mount Pleasant, WI. Our team of family medicine physicians, along with our nurse practitioners, are committed to your health and wellness. We provide comprehensive preventive care, such as annual physical exams and vaccinations. We're also well trained in the diagnosis and treatment of acute illnesses and chronic diseases and can refer you to specialists if needed. We’re Looking For: Completion of an accredited or approved program in nursing Registered Nurse license issued by the state in which the teammate practices Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association What You’ll Do: As a skilled and compassionate RN, you will play a pivotal role in providing and coordinating comprehensive patient care through the nursing process to deliver safe, therapeutic care in accordance with established standards, policies, and procedures. Using evidence-based practice, clinical decision making, compassion, and skills communication while leading efforts to create the safest patient environment and the best patient experience across the continuum. About This Location: A urora Medical Group (AMG) is part of Advocate Health , one of the nation’s largest nonprofit health systems. With more than 350 locations across Illinois and Wisconsin, AMG offers a wide range of specialties and services, including primary care, medical and surgical care, pediatrics, women’s health, behavioral health, and more. Our team is dedicated to delivering exceptional care and improving health outcomes in the communities we serve. Joining AMG means being part of a collaborative, patient-focused environment where innovation and quality care thrive. Be the Nurse Who Redefines Care. At Advocate Health, being a nurse means more than delivering exceptional clinical care—it means leading with purpose, compassion, and boldness. As part of our One Advocate Nurse community, you’ll join a unified team committed to lifting others up, embracing innovation, and creating inclusive spaces where everyone can thrive. You’ll be empowered to think boldly, collaborate with humility, and drive change through fearless curiosity. Whether you're at the bedside, in the community, or advancing care through research and education, you’ll help shape the future of health—because here, we’re redefining care for you, for us, for all. Your feedback matters. Every nurse’s voice is vital in shaping our culture and improving care. We value your insights and experiences because they help us grow stronger together. Ready to Take the Next Step: Apply Now! Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

Travel

Full-time

2 months ago

Travel Nurse RN

Lincoln Park Nursing and Rehab Racine, WI

Seeking Travel Nurses For Our Middleton Location Benefits of (Registered Nurse) RN position: Increased Wages Including Travel Low Cost Health Insurance Vacation and Sick Time Great Work Environment 401k Matched at 10% Flexible Hours (8-hour shifts) Paid Holidays Tuition Assitance Instant Pay (*TapCheck) Robust Employee Appreciation Program Job location: Middleton Middleton Village Nursing and Rehab makes it top priority to care for seniors with the respect, compassion, and dignity they deserve. We understand that caring is what makes a community and without a sense of caring, there can be no sense of community. It is what sets us apart from any other Skilled Nursing Facility. At Middleton Village , our nursing staff are overly courteous, respectful and always maintain a high level of professionalism. Our primary goal is to get you back in a condition to be independent once again while maintaining a friendly environment and providing nutritionally enhanced meals. We are looking for a Registered Nurse (RN) to care for our patients and facilitate their speedy recovery. You will also be responsible for educating them and their families on prevention and healthy habits. The ideal candidate will be a responsible and well-trained professional able to give the best nursing care with little supervision. You will be able to follow health and safety guidelines faithfully and consistently. The goal is to-promote patient’s being-by providing high quality nursing care. Responsibilities: Registered Nurse (RN) Monitor patient’s condition and assess their needs to provide the best possible care and advice Observe and interpret patient’s symptoms and communicate them to physicians Collaborate with physicians and nurses to devise individualized care plans for patients Perform routine procedures (bloods pressure measurements, administering injections etc.) and fill in patients’ charts Adjust and administer patient’s medication and provide treatments according to physician’s orders Inspect the facilities and act to maintain excellent hygiene and safety Supervise and train LPNs and nursing assistants Expand knowledge and capabilities by attending educational workshops, conferences etc. Requirements: Registered Nurse (RN) A minimum of 1-2 years’ experience A team player with excellent communication and interpersonal skills Outstanding organizational and multi-tasking skills Valid nursing license in the state of Wisconsin Apply now to join our team as an RN and help make a real difference! Walk-ins welcome.