Pediatric LTSS Care Manager (RN)

Molina Healthcare; New York (NY); On-site; USD 36,000 - 85,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

Molina Healthcare is seeking aRegistered Nurse (RN) with care management experience to support long-term services and supports (LTSS) and care coordination. You will collaborate with a multidisciplinary team to ensure high-need members receive integrated, high-quality care and cost-effective services.

The role involves assessing and coordinating waiver services, monitoring plans, and ensuring compliance with regulatory timelines.

Qualifications

• Active RN license in the state of practice.
• Minimum 2 years of experience in health care, with care management or LTSS exposure.
• Valid driver's license and reliable transportation for travel.
• Strong verbal and written communication skills and self-motivation.
• Experience with disabilities, chronic conditions, substance use disorders is a plus.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians, and team.
• Monitor care plans, document interventions, and adjust as needed.
• Promote service integration across behavioral health, LTSS, and community resources.
• Assess medical necessity and authorize waiver services; evaluate benefits and funding sources.
• Participate in interdisciplinary care team meetings for service approvals.
• Provide education and motivational interviewing to support member change.
• Identify barriers to care and coordinate resources to address psycho/social, financial, and medical obstacles.
• May mentor peers and handle complex cases and medication reconciliation.

Skills

Communication skills

Time management

Attention to detail

Education

Registered Nurse (RN)

Bachelor's degree in health care field

Tools

Microsoft Office

Job description

Molina Healthcare is seeking aRegistered Nurse (RN) with care management experience to support long-term services and supports (LTSS) and care coordination. You will collaborate with a multidisciplinary team to ensure high-need members receive integrated, high-quality care and cost-effective services.

The role involves assessing and coordinating waiver services, monitoring plans, and ensuring compliance with regulatory timelines.