RN Care Manager – LTSS & Care Coordination

Jobtome; Reynoldsburg (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 provide care management and coordination for LTSS-focused members. You will collaborate with a multidisciplinary team to ensure high-quality, cost-effective care across the continuum, including home visits and waiver services.

Responsibilities include developing and monitoring care plans, facilitating waiver processes, and coordinating interdisciplinary teams. Travel up to 40% may be required depending on state contracts.

Qualifications

• Active RN license in state of practice.
• Minimum 2 years healthcare experience with care management/wellness care.
• Experience with LTSS, disabilities, chronic conditions, or substance use disorders preferred.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including home visits as required.
• Facilitate waiver enrollment/disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians, and other providers.
• Monitor care plans and document interventions and outcomes.
• Promote integrated services across LTSS, behavioral health, and community resources.
• Assess medical necessity and authorize waiver services.
• Evaluate benefits and advise on funding sources.
• Coordinate ICT meetings for service approvals/denials.
• Educate and motivate members using motivational interviewing.
• Identify barriers and provide care coordination for psycho/social/financial/medical issues.
• Identify critical incidents and develop prevention plans.
• May provide consultation/resources to peers.
• Care manager RNs may handle complex cases and med reconciliations.
• Travel 25–40% as required by state/contracts.

Skills

Verbal communication

Written communication

Time management

Detail-oriented

Self-motivation

Interdisciplinary collaboration

Education

Registered Nurse (RN)

Bachelor's degree in a health care field (optional depending on state)

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Registered Nurse to provide care management and coordination for LTSS-focused members. You will collaborate with a multidisciplinary team to ensure high-quality, cost-effective care across the continuum, including home visits and waiver services.

Responsibilities include developing and monitoring care plans, facilitating waiver processes, and coordinating interdisciplinary teams. Travel up to 40% may be required depending on state contracts.