Field-Based RN Care Manager for LTSS & Waiver

Molina Healthcare, Inc.; Lancaster (OH); On-site; USD 36,000 - 71,000; Full time

Job summary

Molina Healthcare seeks a dedicated Registered Nurse care manager to coordinate LTSS services, collaborate with an interdisciplinary team, and drive quality outcomes for members with high-need potential.

You will conduct assessments, develop care plans, monitor progress, and advocate for access to appropriate waiver services while navigating diverse settings and complex needs across the care continuum.

Qualifications

• Minimum 2 years in health care, including care management
• 1+ year with disability, chronic conditions, LTSS preferred
• RN license active and unrestricted in state of practice
• Valid driver’s license and reliable transportation
• Ability to work independently and in diverse settings
• Proactive, detail-oriented and self-motivated
• Strong verbal and written communication skills
• Experience with substance use disorders in some states may be required

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits
• Facilitate waiver enrollment/disenrollment processes
• Develop and implement care plans with members, caregivers and providers
• Monitor care plan effectiveness and adjust as needed
• Promote integration of LTSS with behavioral health and community resources
• Assess medical necessity and authorize waiver services
• Evaluate benefits and funding sources as applicable
• Coordinate ICT meetings for service approvals/denials
• Conduct medication reconciliation as needed
• Travel 25-40% based on state/contract requirements

Skills

Care management

Communication skills

Time-management

Attention to detail

Self-motivation

Independent work

Problem-solving

Organization

Microsoft Office

Interpersonal skills

Education

Registered Nurse (RN) license

Bachelor's degree in health care field

Tools

Microsoft Office

Job description

Molina Healthcare seeks a dedicated Registered Nurse care manager to coordinate LTSS services, collaborate with an interdisciplinary team, and drive quality outcomes for members with high-need potential.

You will conduct assessments, develop care plans, monitor progress, and advocate for access to appropriate waiver services while navigating diverse settings and complex needs across the care continuum.