Care Manager LTSS RN: Coordinated, Outcome-Driven Care

Jobtome; MIDDLETOWN (OH); On-site; USD 36,000 - 71,000; Full time

Job summary

Molina Healthcare is seeking a Nurse Care Manager to support LTSS coordination and care management for high-need members. You will collaborate with multidisciplinary teams to develop and implement comprehensive care plans, monitor progress, and coordinate services across LTSS and behavioral health to ensure quality and cost-effectiveness.

Responsibilities include waiver enrollment, conducting home visits, and traveling as required by state contracts.

Qualifications

• At least 2 years of health care experience including care management/ LTSS exposure.
• Active RN license in the state of practice.
• Bachelor's degree may be required in some states.
• Valid driver's license and reliable transportation for job travel.
• Ability to work independently and manage multiple priorities.
• Proficiency with Microsoft Office and related software.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians, and team members.
• Monitor care plans to evaluate effectiveness and document progress.
• Promote integration of LTSS, behavioral health, and community resources for continuity of care.
• Assess for medical necessity and authorize waiver services.
• Facilitate ICT meetings for approval/denial of services.
• Conduct medication reconciliation as needed.

Skills

Communication skills

Detail-oriented

Problem-solving

Independent work

Education

Registered Nurse license (RN)

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Nurse Care Manager to support LTSS coordination and care management for high-need members. You will collaborate with multidisciplinary teams to develop and implement comprehensive care plans, monitor progress, and coordinate services across LTSS and behavioral health to ensure quality and cost-effectiveness.

Responsibilities include waiver enrollment, conducting home visits, and traveling as required by state contracts.