RN Care Manager, LTSS & Waiver Services

Molina Healthcare, Inc.; Plymouth (MA); On-site; USD 90,000 - 120,000; Full time

Job summary

Molina Healthcare, Inc. seeks a Registered Nurse Care Manager to support LTSS care coordination and care management activities.

You will collaborate with multidisciplinary teams to ensure high-need members receive integrated, quality and cost-efficient care across the continuum. The role requires an active RN license, 2+ years in health care with 1 year in care management, and willingness to travel 25-40% to fulfill state/contractual requirements.

Qualifications

• At least 2 years in health care, including 1 year in care management or LTSS.
• Active RN license in state of practice.
• Valid driver's license and reliable transportation.
• Experience with persons with disabilities, chronic conditions, LTSS.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans with members and care network to address needs.
• Monitors care plan progress, documents interventions and outcomes.
• Promotes integration of LTSS and behavioral health services.
• Assesses medical necessity and authorizes applicable waiver services.
• Conducts ICT meetings for approval/denial of services.
• May provide consultation and resources to peers; travel 25-40% as required.

Skills

Verbal communication

Written communication

Time management

Problem solving

Independent work

Microsoft Office

Multi-tasking

Education

Registered Nurse (RN) license

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. seeks a Registered Nurse Care Manager to support LTSS care coordination and care management activities.

You will collaborate with multidisciplinary teams to ensure high-need members receive integrated, quality and cost-efficient care across the continuum. The role requires an active RN license, 2+ years in health care with 1 year in care management, and willingness to travel 25-40% to fulfill state/contractual requirements.