RN Care Manager: LTSS & Waiver Services (Travel)

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

Benefits offered by this job

Competitive benefits

Equal Opportunity Employer (EOE)

Job summary

Molina Healthcare is seeking an RN Care Manager to support care management and LTSS activities, collaborating with multidisciplinary teams to coordinate member care across the continuum. The role focuses on ensuring progress toward outcomes and contributing to quality, cost-effective care.

The incumbent will conduct comprehensive assessments, develop and monitor care plans, facilitate waiver processes, and promote integration across services, including behavioral health and community resources.

Qualifications

• At least 2 years of health care experience including care management/ LTSS.
• RN license active and unrestricted in state of practice.
• Bachelor's degree in health care field may be required depending on state.
• Valid driver's license and reliable transportation for travel requirements.
• Ability to operate proactively and be detail-oriented.
• Demonstrated knowledge of community resources.
• Ability to work in diverse settings with diverse populations.
• Ability to work independently with minimal supervision.
• Strong verbal and written communication skills.
• Proficiency in Microsoft Office.
• In some states, at least one year of experience with individuals with substance use disorders.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians and care network.
• Monitor care plan effectiveness and document interventions and goal achievement.
• Promote integration of LTSS with behavioral health and community resources.
• Assess medical necessity and authorize waiver services.
• Evaluate covered benefits and advise on funding sources.
• Facilitate ICT meetings for approval/denial of services.
• Educate, support and motivate change using motivational interviewing and Molina guides.
• Assess barriers to care and provide care coordination for psycho/social, financial, and medical obstacles.
• Identify critical incidents and develop prevention plans.
• Provide consultation to peers as needed.
• Care manager RNs may handle complex cases and medication regimens.
• RNs may conduct medication reconciliation.
• Travel 25-40% depending on state/contractual requirements.

Skills

Communication

Time management

Self-motivation

Microsoft Office

Problem-solving

Proactive attitude

Adaptability

Team collaboration

Education

RN license

Bachelor's degree (healthcare)

Tools

Microsoft Office Suite

Job description

Molina Healthcare is seeking an RN Care Manager to support care management and LTSS activities, collaborating with multidisciplinary teams to coordinate member care across the continuum. The role focuses on ensuring progress toward outcomes and contributing to quality, cost-effective care.

The incumbent will conduct comprehensive assessments, develop and monitor care plans, facilitate waiver processes, and promote integration across services, including behavioral health and community resources.