RN Care Navigator for LTSS & Waiver Services

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

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare, Inc. is seeking a Care Manager RN to support LTSS care coordination and multidisciplinary collaboration. The role involves conducting home visits, developing individualized care plans, and ensuring services align with member goals while navigating regulatory requirements.

You will coordinate waiver services, monitor outcomes, and facilitate ICT meetings. Travel up to 40% may be required based on state contracts and client needs.

Qualifications

• Minimum 2 years in health care with care management exposure.
• Experience with persons with disabilities, chronic conditions, LTSS or equivalent.
• Active RN license in state of practice; valid driver’s license.

Responsibilities

• Complete comprehensive member assessments within timelines.
• Coordinate waiver enrollment/disenrollment processes.
• Develop and implement care plans with the member and care network.
• Monitor care plan effectiveness and adjust as needed.
• Promote integrated care across behavioral health and LTSS.
• Assess medical necessity and authorize waiver services.
• Lead ICT meetings for service approvals/denials.
• Travel 25–40% depending on state/contract.

Skills

Care coordination

Multidisciplinary collaboration

Communication skills

Documentation accuracy

Proactive problem solving

Education

Registered Nurse (RN) license active

Bachelor’s degree in healthcare field (may be required)

Job description

Molina Healthcare, Inc. is seeking a Care Manager RN to support LTSS care coordination and multidisciplinary collaboration. The role involves conducting home visits, developing individualized care plans, and ensuring services align with member goals while navigating regulatory requirements.

You will coordinate waiver services, monitor outcomes, and facilitate ICT meetings. Travel up to 40% may be required based on state contracts and client needs.