Remote RN Care Manager - LTSS & Maternity Care (Telephonic)

Molina Healthcare; Texas; Remote; USD 70,000 - 95,000; Full time

Job summary

Molina Healthcare is seeking a Texas-licensed Registered Nurse Case Manager to support members in OB/L&D/postpartum through telephonic care coordination within our Texas Health Plan. The role involves assessments, care planning, and coordinating LTSS across teams, with a focus on high-need members.

The ideal candidate has 2+ years in healthcare with care management experience, strong MS Office skills, and willingness to travel 25-40% for state-based requirements.

Qualifications

• At least 2 years of experience in health care, including at least 1 year in care management, managed care, or LTSS settings.
• RN licensure active and unrestricted in state of practice.
• Bachelor's degree in health care related field may be required depending on state/contract.
• Valid driver's license and ability to travel as required.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits when required.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members and providers.
• Monitor care plans, document interventions, and adjust as needed.
• Promote integrated services and LTSS to improve continuity of care.
• Assess medical necessity and authorize waiver services.
• Coordinate interdisciplinary care team meetings for approvals.
• Educate and motivate members using motivational interviewing and Molina guidelines.
• Identify barriers to care and assist with psycho-social, financial, and medical needs.
• Identify critical incidents and develop prevention plans.

Skills

Care coordination

Communication skills

Independent work

Patient advocacy

Travel readiness

Education

Bachelor's degree in health care related field

Tools

Microsoft Office

Outlook

Excel

Teams

Job description

Molina Healthcare is seeking a Texas-licensed Registered Nurse Case Manager to support members in OB/L&D/postpartum through telephonic care coordination within our Texas Health Plan. The role involves assessments, care planning, and coordinating LTSS across teams, with a focus on high-need members.

The ideal candidate has 2+ years in healthcare with care management experience, strong MS Office skills, and willingness to travel 25-40% for state-based requirements.