RN Care Manager (LTSS) - Field-Based Care Coordinator

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

Job summary

Molina Healthcare, Inc. is seeking an RN Care Manager to support care management and coordination for LTSS-focused activities across multiple Ohio counties.

The role collaborates with a multidisciplinary team to ensure high-need members progress toward outcomes and cost-effective, quality care. Responsibilities include comprehensive assessments, waiver processes, care plan development, and ongoing monitoring.

Qualifications

• At least 2 years of health care experience with at least 1 year in care management or managed care, and LTSS exposure.
• Active RN license in state of practice.
• In some states, a bachelor's degree in a health care related field may be required.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians, and support networks.
• Monitors care plan effectiveness and documents interventions and goal achievement.
• Promotes integration of services including behavioral health and LTSS to ensure continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and advises on funding sources.
• Facilitates interdisciplinary care team meetings for service approvals/denials.
• Uses motivational interviewing and Molina clinical guideposts to educate and support change.
• Assesses barriers to care and provides coordination for psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans.
• May provide consultation to peers as needed.
• Care manager RNs may handle complex member cases and medication reconciliation.
• Travel 25-40% may be required based on state/contractual requirements.

Skills

Care management

Managed care

Disabilities

Chronic conditions

Substance use disorders

LTSS

Communication skills

Time management

Prioritization

Problem solving

Detail-oriented

Travel readiness

Education

RN license

Bachelor's degree in health care field

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. is seeking an RN Care Manager to support care management and coordination for LTSS-focused activities across multiple Ohio counties.

The role collaborates with a multidisciplinary team to ensure high-need members progress toward outcomes and cost-effective, quality care. Responsibilities include comprehensive assessments, waiver processes, care plan development, and ongoing monitoring.