Field-Based RN Care Manager: LTSS & Waiver Coordination

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

Job summary

Molina Healthcare, Inc. is seeking a Care Manager RN to support care management and LTSS activities across multiple counties in Ohio.

You will collaborate with an interdisciplinary team to coordinate member care and ensure progress toward outcomes. Primary responsibilities include conducting comprehensive assessments, facilitating waiver processes, and developing care plans with member, caregivers and providers.

Qualifications

• RN license required and active in practice state.
• 2+ years health care experience incl care management.
• Driver's license and travel availability.
• Ability to work independently and with diverse populations.
• Knowledge of community resources and LTSS.
• Experience with disability, chronic conditions, substance use disorders optional.

Responsibilities

• Complete comprehensive member assessments within timelines, including home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members and care network.
• Monitor and adjust care plans based on progress and barriers.
• Promote integration of behavioral health and LTSS services.
• Assess medical necessity and authorize waiver services.
• Coordinate ICT meetings for service approvals/denials.
• Provide education and motivation during member contacts.
• Identify barriers to care and address psychosocial/financial obstacles.
• Identify incidents and develop prevention plans.
• May provide peer consultation as needed.
• May handle complex cases and medication reconciliation.

Skills

Verbal and written communication

Time management

Problem solving

Attention to detail

Self-motivation

Education

Registered Nurse (RN) license

Tools

Microsoft Office

Electronic Health Records (EHR)

Job description

Molina Healthcare, Inc. is seeking a Care Manager RN to support care management and LTSS activities across multiple counties in Ohio.

You will collaborate with an interdisciplinary team to coordinate member care and ensure progress toward outcomes. Primary responsibilities include conducting comprehensive assessments, facilitating waiver processes, and developing care plans with member, caregivers and providers.