RN Care Manager: LTSS & Waiver Coordination (Travel)

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

Benefits offered by this job

Competitive benefits

Equal Opportunity Employer

Job summary

Molina Healthcare, Inc. seeks an experienced RN Care Manager to support care management and LTSS activities in Ohio. You will collaborate with a multidisciplinary team to coordinate member care, develop and monitor care plans, and ensure services meet medical necessity and member goals.

The role requires strong communication, problem-solving, and ability to work independently, with travel up to 40% as required by state contracts. RN license active in state of practice is required.

Qualifications

• At least 2 years of health care experience including 1 year in care management or LTSS, or equivalent education/experience.
• RN license active and unrestricted in state of practice.
• In some states a healthcare-related bachelor's degree may be required.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Develops and implements care plans with members, caregivers, physicians and team.
• Performs ongoing monitoring of care plan effectiveness and documents progress.
• Promotes integration of services for LTSS and behavioral health to improve continuity of care.
• Assesses medical necessity and authorizes waiver services; evaluates benefits and funding sources.
• Facilitates ICT meetings for approval/denial of services and collaboration.
• Educates and motivates members using motivational interviewing and Molina guidelines.
• Identifies barriers to care and provides resources for psycho/social, financial, and medical needs.
• May conduct medication reconciliation and complex case management as needed.
• Local travel 25-40% may be required.

Skills

Care coordination

Communication

Time management

Detail-oriented

Problem solving

Self-motivation

Multicultural sensitivity

Organization

Education

Registered Nurse (RN) license

Bachelor's degree in healthcare field (optional/depending on state)

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. seeks an experienced RN Care Manager to support care management and LTSS activities in Ohio. You will collaborate with a multidisciplinary team to coordinate member care, develop and monitor care plans, and ensure services meet medical necessity and member goals.

The role requires strong communication, problem-solving, and ability to work independently, with travel up to 40% as required by state contracts. RN license active in state of practice is required.