RN Care Manager – LTSS & Waiver Services

Jobtome; Euclid (OH); On-site; USD 36,000 - 71,000; Full time

Job summary

Molina Healthcare is seeking a Registered Nurse Care Manager to support care management and care coordination for LTSS. You will collaborate with a multidisciplinary team to ensure timely assessments, waiver enrollment, and effective care planning across counties.

The role involves coordinating services, monitoring outcomes, and navigating medical necessity and funding sources while engaging with members, caregivers, and health professionals.

Qualifications

• At least 2 years in health care, including 1 year in care management or LTSS
• RN license active and unrestricted in state of practice
• In some states, a health-care degree may be required
• Valid driver's license and reliable transportation for travel
• Ability to operate proactively and manage multiple tasks

Responsibilities

• Complete comprehensive member assessments within regulated timelines
• Facilitate waiver enrollment and disenrollment processes
• Develop and implement care plans with members and care network
• Monitor care plans and document interventions and outcomes
• Promote integration of behavioral health and LTSS services
• Assess medical necessity and authorize waiver services
• Evaluate benefits and advise on funding sources
• Coordinate ICT meetings for service decisions
• Use motivational interviewing to support member change
• Identify barriers and provide care coordination for psycho/social needs
• Develop prevention plans for member health and welfare
• Provide consultation to peers as needed
• May handle complex member cases and medication reconciliation
• Travel 25-40% as required

Skills

RN License

Driver's license

Communication skills

Time management

Detail oriented

Proactive

Multidisciplinary collaboration

Education

Bachelor's degree in health care field

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Registered Nurse Care Manager to support care management and care coordination for LTSS. You will collaborate with a multidisciplinary team to ensure timely assessments, waiver enrollment, and effective care planning across counties.

The role involves coordinating services, monitoring outcomes, and navigating medical necessity and funding sources while engaging with members, caregivers, and health professionals.