RN Care Manager: Complex LTSS & Waiver Coordination

Socket.dev; Long Beach (CA); On-site; USD 70,000 - 100,000; Full time

Job summary

Molina Healthcare is seeking a Care Manager RN to support LTSS care coordination and care management. The role involves collaborating with a multidisciplinary team to coordinate comprehensive member care and ensure progress toward outcomes.

Responsibilities include assessments, care plan development, monitoring, and authorization of waiver services. Travel up to 40% may be required depending on contracts and state needs.

Qualifications

• 2+ years in health care with care management experience.
• RN license must be active and unrestricted.
• State/contractual requirements may apply.
• Valid driver's license and reliable transportation.
• Ability to travel locally 25-40% as required.

Responsibilities

• Complete comprehensive member assessments within timelines, including in-person home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians and care team.
• Monitor care plans and adjust interventions to achieve goals.
• Promote integration of LTSS, behavioral health and community resources.
• Assess medical necessity and authorize waiver services.
• Coordinate ICT meetings for service approvals/denials.
• Educate and motivate members using motivational interviewing.
• Identify barriers and coordinate psycho/social, financial, and medical support.
• Provide consultation to peers as needed.
• RNs may handle complex cases and medication reconciliation.

Skills

Care management experience

Communication skills

Time management

Independence

Travel readiness

Education

RN license (active, unrestricted)

Driver's license

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Care Manager RN to support LTSS care coordination and care management. The role involves collaborating with a multidisciplinary team to coordinate comprehensive member care and ensure progress toward outcomes.

Responsibilities include assessments, care plan development, monitoring, and authorization of waiver services. Travel up to 40% may be required depending on contracts and state needs.