RN Care Manager - LTSS & Care Coordination

Jobtome; Kansas; On-site; USD 38,000 - 74,000; Full time

Job summary

Molina Healthcare is seeking a registered nurse care manager to provide LTSS care coordination, collaborate with an interdisciplinary team, and drive care plans toward outcomes. The role involves assessments, waiver processes, and integration of behavioral health and community resources.

Travel up to 40% locally, requires active RN license, and strong communication, documentation, and problem-solving skills to support members with disabilities and chronic conditions.

Qualifications

• At least 2 years of experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• May provide consultation, resources and recommendations to peers as needed.
• Care manager RNs may be assigned complex member cases and medication regimens.
• Care manager RNs may conduct medication reconciliation as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Skills

RN

Care management

Communication skills

Time management

Microsoft Office

Driver's license

Travel readiness

Self-motivation

Education

RN nursing license

Bachelor's degree in health care field

Job description

Molina Healthcare is seeking a registered nurse care manager to provide LTSS care coordination, collaborate with an interdisciplinary team, and drive care plans toward outcomes. The role involves assessments, waiver processes, and integration of behavioral health and community resources.

Travel up to 40% locally, requires active RN license, and strong communication, documentation, and problem-solving skills to support members with disabilities and chronic conditions.