Care Manager RN — LTSS & Care Coordination

Molina Healthcare, Inc.; City of Yonkers (NY); On-site; USD 36,000 - 85,000; Full time

Job summary

Molina Healthcare, Inc. is seeking an experienced RN care manager to support LTSS-focused care coordination. You will collaborate with a multidisciplinary team to plan, monitor, and adjust member care across settings, aiming for improved outcomes and cost-effective care.

Responsibilities include comprehensive assessments, waiver processes, and care-plan development with providers and families. Travel may be required to deliver in-home and community-based services.

Qualifications

• Registered Nurse (RN) with active NY license.
• At least 2 years in health care, including care management or managed care.
• Experience with persons with disabilities, chronic conditions or LTSS.
• Valid driver's license, reliable transportation, and auto insurance.
• Proactive, detail-oriented, and able to work independently.
• Proficient in Microsoft Office and related software.
• Experience with substance use disorders is a plus.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians and support networks.
• Monitors care plan effectiveness and documents interventions and goal achievement.
• Promotes integration of services to enhance continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and advises on funding sources.
• Coordinates ICT meetings for approvals or denials of services.
• Uses motivational interviewing to educate and motivate change.
• Addresses psycho/social, financial, and medical barriers to care.
• Travel 25-40% may be required.

Skills

RN license

Care management

Managed care

Disabilities support

Substance use disorders

Communication skills

Time management

Education

Bachelor's degree in health care

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. is seeking an experienced RN care manager to support LTSS-focused care coordination. You will collaborate with a multidisciplinary team to plan, monitor, and adjust member care across settings, aiming for improved outcomes and cost-effective care.

Responsibilities include comprehensive assessments, waiver processes, and care-plan development with providers and families. Travel may be required to deliver in-home and community-based services.