RN Care Manager: LTSS & Waiver Services Navigator

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

Job summary

Molina Healthcare is seeking an experienced RN Care Manager to support care coordination for members requiring LTSS. You will collaborate with a multidisciplinary team to develop and implement comprehensive care plans, monitor progress, and coordinate waiver services to improve outcomes and cost-effectiveness.

The role demands an active RN license, at least two years in healthcare with care-management exposure, strong communication, and the ability to travel locally up to 40%.

Qualifications

• 2+ years in healthcare, with at least 1 year in care management or LTSS
• RN license active and unrestricted in state of practice
• Bachelor's degree in health care field may be required in some states
• Valid driver's license and reliable transportation for travel requirements
• Ability to work independently and manage multiple tasks effectively
• Proficiency in communicating with diverse populations and coordination with multidisciplinary teams

Responsibilities

• Complete comprehensive member assessments within timelines, including home visits
• Facilitate waiver enrollment/disenrollment processes
• Develop and implement care plans with members and care network
• Monitor care plan effectiveness and adjust interventions as needed
• Promote integration of LTSS with behavioral health services and community resources
• Assess medical necessity and authorize waiver services
• Coordinate ICT meetings for service approvals/denials
• Educate and motivate members using motivational interviewing
• Identify barriers to care and address psycho/social, financial, and medical obstacles
• Travel locally 25–40% as required by state/contractual terms

Skills

Care coordination

Communication

Time management

Microsoft Office

Documentation

Education

RN license

Bachelor's degree (healthcare)

Tools

Microsoft Office

Job description

Molina Healthcare is seeking an experienced RN Care Manager to support care coordination for members requiring LTSS. You will collaborate with a multidisciplinary team to develop and implement comprehensive care plans, monitor progress, and coordinate waiver services to improve outcomes and cost-effectiveness.

The role demands an active RN license, at least two years in healthcare with care-management exposure, strong communication, and the ability to travel locally up to 40%.