RN Care Manager — LTSS & Waiver Services

Molina Healthcare, Inc.; Johnstown (OH); Presencial; USD 36.000 - 71.000; Jornada completa

Descripción de la vacante

Molina Healthcare, Inc. is seeking a Registered Nurse care manager to support care management and care coordination for LTSS.

You will collaborate with a multidisciplinary team to deliver integrated member care and advance outcomes while aligning with organizational strategy for quality and cost-effective care. Responsibilities include completing assessments, developing care plans with waiver services, monitoring progress, coordinating with ICT meetings, and navigating funding sources.

Formación

• At least 2 years of health care experience including care management and LTSS.
• RN license active and unrestricted in state of practice.
• Bachelor’s degree in a health care related field may be required depending on state.
• Valid and reliable transportation for travel as needed.

Responsabilidades

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with waiver services in collaboration with members and care network.
• Monitors care plans and documents interventions and goal achievement.
• Promotes integration of LTSS and behavioral health with community resources.
• Assesses medical necessity and authorizes waiver services.
• Participates in ICT meetings for approval/denial of services.
• Educates and motivates members using motivational interviewing and Molina clinical guidelines.
• Identifies barriers to care and coordinates solutions for psycho/social and medical needs.
• Leads or collaborates on complex cases and medication reconciliation as needed.
• 75–40% (5–7) local travel may be required based on state contracts.

Conocimientos

Care coordination

Communication

Time management

Problem solving

Independent work

Educación

Registered Nurse (RN)

Bachelor's degree (health care related)

Valid driver's license

Herramientas

Microsoft Office

Descripción del empleo

Molina Healthcare, Inc. is seeking a Registered Nurse care manager to support care management and care coordination for LTSS.

You will collaborate with a multidisciplinary team to deliver integrated member care and advance outcomes while aligning with organizational strategy for quality and cost-effective care. Responsibilities include completing assessments, developing care plans with waiver services, monitoring progress, coordinating with ICT meetings, and navigating funding sources.