RN Care Manager - LTSS & Waiver Services

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

Job summary

Molina Healthcare is seeking a registered nurse care manager in Ohio to support care management and care coordination for members with high-need potential. You will collaborate with multidisciplinary teams to design and implement LTSS plans, monitor progress, and promote integrated services across home and community settings.

The role requires strong assessment, documentation, and communication skills; travel 25-40% may be required; licensure and clean driving record essential.

Qualifications

• Active RN license in state of practice.
• 2+ years in health care with care management or related LTSS exposure.
• Experience with disability, chronic conditions or behavioral health is a plus.
• Valid driver’s license and reliable transportation for travel.

Responsibilities

• Completes comprehensive member assessments within regulated timelines and conducts in-person visits as required.
• Facilitates waiver enrollment and disenrollment processes.
• Develops care plans with member, caregivers and providers to meet needs and goals.
• Monitors care plan effectiveness and documents interventions and outcomes.
• Promotes integration of services across LTSS and community resources.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and funding sources.
• Facilitates ICT meetings for approval/denial of services.
• Uses motivational interviewing to educate and motivate change.
• Identifies barriers and coordinates care to address psycho/social/financial/medical obstacles.
• Identifies critical incidents and develops prevention plans.
• May provide consultation to peers.
• Care manager RNs may handle complex cases and medication reconciliation.
• 25-40% local travel may be required.

Skills

RN License

Care management experience

Healthcare experience

Communication skills

Travel readiness

Education

RN License

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a registered nurse care manager in Ohio to support care management and care coordination for members with high-need potential. You will collaborate with multidisciplinary teams to design and implement LTSS plans, monitor progress, and promote integrated services across home and community settings.

The role requires strong assessment, documentation, and communication skills; travel 25-40% may be required; licensure and clean driving record essential.