RN Care Manager, LTSS & Waiver Services

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

Job summary

Molina Healthcare is hiring a Care Manager RN to support care coordination and LTSS areas across multiple counties in Ohio. You will perform comprehensive assessments, develop and monitor care plans, and coordinate with a multidisciplinary team to ensure high-quality, cost-effective member care.

You will facilitate waiver processes, ensure medical necessity and benefits are correctly managed, and engage in ICT meetings while traveling regionally to member sites as needed.

Qualifications

• RN license active and unrestricted in state of practice.
• 2+ years in health care with care management or LTSS exposure.
• Experience with persons with disabilities or chronic conditions.
• Ability to travel regionally for member visits.

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 and providers.
• Monitors care plans and documents outcomes; adjusts as needed.
• Promotes integrated services including behavioral health and LTSS.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and advises on funding sources.
• Facilitates ICT meetings for service approvals.
• Uses motivational interviewing and Molina guides to support change.
• Identifies barriers to care and provides coordination to address obstacles.
• Identifies incidents and develops prevention plans for member welfare.
• May provide consultation to peers.
• RNs may handle complex cases and medication regimens; may perform reconciliation.
• 25-40% local travel may be required.

Skills

Healthcare experience

Care management

Independent work

Communication skills

Problem solving

Microsoft Office

Substance use disorders experience

Driver's license

Education

Registered Nurse (RN) license

Bachelor's degree in health care field

Tools

Microsoft Office

Job description

Molina Healthcare is hiring a Care Manager RN to support care coordination and LTSS areas across multiple counties in Ohio. You will perform comprehensive assessments, develop and monitor care plans, and coordinate with a multidisciplinary team to ensure high-quality, cost-effective member care.

You will facilitate waiver processes, ensure medical necessity and benefits are correctly managed, and engage in ICT meetings while traveling regionally to member sites as needed.