RN Care Manager — LTSS & Waiver Specialist

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

Job summary

Molina Healthcare in the United States is seeking a Registered Nurse to support care management and coordination for members with high-need potential across LTSS. You will collaborate with a multidisciplinary team to ensure quality and cost-effective care and help members progress toward their health goals.

The role includes completing member assessments, coordinating waiver services, developing care plans, monitoring outcomes, and traveling locally up to 40% as required.

Qualifications

• At least 2 years of health care experience including 1 year in care management/LTSS
• RN with active license in state of practice
• Valid driver’s license and reliable transportation
• Ability to work independently and with minimal supervision
• Strong verbal and written communication skills

Responsibilities

• Completes comprehensive member assessments within timelines, including in-person home visits
• Facilitates comprehensive waiver enrollment and disenrollment processes
• Develops and implements care plans with members and care network
• Performs ongoing monitoring of care plan and documents interventions
• Promotes integration of LTSS and behavioral health with community resources
• Assesses medical necessity and authorizes waiver services
• Evaluates benefits and funding sources
• Facilitates ICT meetings for approvals/denials
• Uses motivational interviewing to educate and motivate change
• Identifies barriers to care and provides care coordination
• Identifies critical incidents and develops prevention plans
• May provide consultation to peers
• Care manager RNs may handle complex cases and medication reconciliation
• Travel 25-40% may be required

Skills

RN

Care management experience

Communication skills

Microsoft Office

Travel readiness

Education

Bachelor’s degree in healthcare

CCM certification (preferred)

Tools

Microsoft Office

Job description

Molina Healthcare in the United States is seeking a Registered Nurse to support care management and coordination for members with high-need potential across LTSS. You will collaborate with a multidisciplinary team to ensure quality and cost-effective care and help members progress toward their health goals.

The role includes completing member assessments, coordinating waiver services, developing care plans, monitoring outcomes, and traveling locally up to 40% as required.