Remote Insurance Nurse Jobs in Racine, WI (NOW HIRING)

JOB DESCRIPTION Job Summary

Job Summary 

TMG is on the lookout for our next great Eligibility Screener! If you love doing meaningful work that helps others live their best lives, we want to hear from you!  

We’re currently in search for someone with a background in human services, social work, healthcare or case management to join our team. This is a remote position, where you will partner with people in your community who use the TMG IRIS Consultant Agency. While this role is home-based, you will spend most days visiting IRIS participants in their homes. While you’ll have a routine for the work that you do, no two days are alike!

As an Eligibility Screener, you would be responsible for completing the Adult Long-Term Care Functional Screens (LTC-FS) for participants of the Wisconsin IRIS program – a Medicaid long-term care option for older adults and people with disabilities. The job includes completing annual rescreens and any change-in-condition screens using the Adult LTC-FS tool to ensure program eligibility. Successful candidates will be approachable, compassionate and respectful of people of all different backgrounds and abilities, and be able to see and articulate the strengths that people inherently have.  

TMG is committed to maintaining a diverse and inclusive workforce, and prioritizes helping staff have a good work/life balance. Even though the position is remote, you’ll have lots of support from your TMG team and coworkers across the organization. If this sounds like the job for you, apply today!

Job Duties 

• Meets with IRIS participants face to face to complete the screening process. 
• Completes the Adult Long Term Care Functional Screen (LTC-FS) for people in IRIS according to the Wisconsin Adult LTC-FS Instructions. 
• Completes contacts to verify screen results with IRIS Consultants, Medicaid Personal Care agencies, and verifies diagnosis information with physicians and the Social Security Administration, when needed.  
• Meets the highest standards of documentation and program regulations, while ensuring timely completion of  screens. 
• Maintains screening skills by participating in weekly team meetings, monthly All Screener Meetings, trainings and testing. 
• Other duties as assigned by management. 
   

Required Qualifications

• At least 2 years experience in health care, preferably in care coordination, and least 1 year of experience serving target groups of the IRIS program (adults with physical/intellectual disabilities or older adults), or equivalent combination of relevant education and experience. 
• Must be currently certified to conduct/administer the adult long-term care functional screens or pass the Wisconsin adult long-term care functional screen certification modules (80% or higher on each module) within first week of hire and maintain certification as a screener. 
• Bachelor of arts or science degree or more advanced degree in a health or human services related field (e.g. social work, psychology) or graduate from an accredited school of nursing. 
• If a graduate from an accredited school of nursing, must have an active and unrestricted Wisconsin Registered Nurse (RN) license in good standing. 
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. 
• Attention to detail and ability to ensure accuracy of data. 
• Strong organizational and time-management skills. 
• Strong customer service skills and the ability to work cooperatively as part of a team and independently. 
• Ability to remain flexible in the work environment and willing and able to adapt to changing organizational needs. 
• Excellent verbal and written communication skills. 
• Demonstrated computer and software skills required including Microsoft Office suite/applicable software program(s) proficiency. 
• Travel Requirements 5%.
 

Preferred Qualifications

• Current or former certification to conduct/administer adult Long-Term Care Functional Screening (LTCFS) in the state of Wisconsin.
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: $19.84 - $38.69 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.