RN Care Manager for LTSS & Waiver Services

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

Benefits offered by this job

Competitive benefits package

Job summary

Molina Healthcare is seeking a Registered Nurse to support care management and LTSS activities across multiple counties in Ohio. You will coordinate assessments, waiver enrollments, and care plans in collaboration with members, caregivers, physicians, and care teams.

The role involves ensuring service coordination, evaluating medical necessity, and promoting integration of behavioral health and LTSS. Travel to local sites will be required as per state contracts.

Qualifications

• Registered Nurse (RN) with active license in state of practice.
• Bachelor's degree in health care field may be required in some states.
• Must have valid driver's license and reliable transportation for travel requirements.
• Experience in care management, managed care, LTSS, or related settings is required.

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 care plans and adjust as needed to achieve goals.
• Coordinate services to integrate behavioral health and LTSS.
• Assess medical necessity and authorize waiver services.
• Participate in ICT meetings for service approvals/denials.
• Travel 25-40% locally as required by state/contract.

Skills

Communication skills

Microsoft Office

Time management

Self-motivation

Education

Bachelors in healthcare or related field

RN license

Tools

MS Office

Job description

Molina Healthcare is seeking a Registered Nurse to support care management and LTSS activities across multiple counties in Ohio. You will coordinate assessments, waiver enrollments, and care plans in collaboration with members, caregivers, physicians, and care teams.

The role involves ensuring service coordination, evaluating medical necessity, and promoting integration of behavioral health and LTSS. Travel to local sites will be required as per state contracts.