Registered Nurse Case Manager in Sun Prairie, WI

• **Sign-on bonus available for eligible candidates*** JOB DESCRIPTION Job Summary Join Molina Healthcare Services in providing exceptional care to members with complex needs. Our team collaborates with members, providers, and multidisciplinary professionals to assess, plan, and coordinate comprehensive care, promoting the well-being and health of our patients with long-term care and behavioral health requirements. KEY RESPONSIBILITIES • Conduct face-to-face comprehensive assessments of members within regulated timelines. • Facilitate the enrollment and disenrollment processes for comprehensive waivers. • Develop and implement case management and waiver service plans in collaboration with the member, their family, and healthcare professionals. • Monitor and evaluate care plans for effectiveness, documenting interventions and achievements. • Integrate services for members, including access to behavioral health care and supporting long-term services. • Assess medical necessity and authorize appropriate waiver services. • Evaluate covered benefits and provide guidance on funding sources. • Conduct required home visits or face-to-face appointments. • Lead interdisciplinary care team meetings for service approvals or denials. • Utilize motivational interviewing techniques to educate and empower members during engagements. • Address barriers to care and provide assistance for psychosocial, financial, and medical concerns. • Identify critical incidents and develop preventive plans to ensure member welfare. • Consult and offer recommendations to non-RN case managers when necessary. • Manage cases involving complex medical conditions and medication regimens. • Perform medication reconciliation as needed. • Travel required: 50-75%. QUALIFICATIONS Required Education Must be a graduate of an accredited school of nursing. Required Experience • A minimum of 1 year working with individuals with disabilities or chronic conditions, particularly in Long Term Services and Supports. • 1-3 years in roles related to case management, disease management, or in managed care/healthcare settings. Required Licenses/Certifications • Active, unrestricted RN license in good standing. • Valid driver's license and reliable transportation for travel. State Specific Requirements If located in Virginia: At least one year of experience working directly with individuals with Substance Use Disorders. Preferred Education Bachelor's Degree in Nursing. Preferred Experience • 3-5 years in case management, disease management, or related healthcare settings. • Experience working with populations receiving waiver services preferred. Preferred Certification Active and unrestricted Certified Case Manager (CCM) certification. Note to Current Molina Employees: Please apply through the intranet job listing if interested. Molina Healthcare offers a competitive benefits and compensation package. We are 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.