RN Care Manager, LTSS & Care Coordination

Molina Healthcare, Inc.; Ravenna (OH); Presencial; USD 36.000 - 71.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive benefits

Equal Opportunity Employer

Descripción de la vacante

Molina Healthcare, Inc. seeks an experienced RN to support care management and LTSS-related activities across multiple counties. You will collaborate with a multidisciplinary team to coordinate integrated member care and work toward desired outcomes.

The role involves facilitating waiver enrollment, developing care plans with members and providers, and traveling locally as required (25-40%). A valid RN license and 2+ years in healthcare are required.

Formación

• Requires RN license active and unrestricted in state of practice.
• Minimum 2 years healthcare experience with at least 1 year in care management or managed care.
• Experience working with persons with disabilities, chronic conditions, or LTSS preferred.
• Proficiency with MS Office and related software.

Responsabilidades

• Completes comprehensive member assessments within timelines, including home visits as needed.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians, and team.
• Monitors care plans, documents interventions, and adjusts goals as needed.
• Promotes service integration across behavioral health and LTSS.
• Assesses medical necessity and authorizes waiver services.
• Advocates for funding sources and evaluates benefits.
• Facilitates ICT meetings for approvals/denials and collaboration.
• Uses motivational interviewing to educate and motivate change.
• Identifies barriers to care and coordinates solutions for psycho/social, financial, and medical issues.
• Identifies critical incidents and develops prevention plans.
• May provide consultation to peers and handle complex cases.

Conocimientos

Care management

Managed care

Behavioral health

LTSS experience

Disabilities experience

Educación

RN license

Bachelor's degree in healthcare

Herramientas

MS Office

Descripción del empleo

Molina Healthcare, Inc. seeks an experienced RN to support care management and LTSS-related activities across multiple counties. You will collaborate with a multidisciplinary team to coordinate integrated member care and work toward desired outcomes.

The role involves facilitating waiver enrollment, developing care plans with members and providers, and traveling locally as required (25-40%). A valid RN license and 2+ years in healthcare are required.