RN LTSS Care Manager: Care Coordination & Outcomes

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

Job summary

Molina Healthcare, Inc. is hiring a Care Manager RN to support LTSS care coordination across the care continuum.

You will work with a multidisciplinary team to assess needs, enroll waivers, develop and monitor care plans, and ensure quality outcomes for high-need members. The role requires at least 2 years in health care with a focus on care management, an active RN license, and willingness to travel locally (25-40%).

Qualifications

• 2+ years in health care with at least 1 year in care management, managed care, or LTSS.
• RN license active and unrestricted in state of practice.
• Bachelor's degree in a health care related field may be required in some states.
• Valid driver's license, reliable transportation for job travel.
• Proactive, detail-oriented, and able to work with minimal supervision.
• Knowledge of community resources and ability to work with diverse populations.
• Strong written and verbal communication skills.
• Experience with substance use disorders is a plus in some states.
• Proficiency with Microsoft Office and basic software tools.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop care plans with members, caregivers, physicians, and other health care professionals.
• Monitor and document progress, evaluating effectiveness and adjusting as needed.
• Promote integration of LTSS and behavioral health services.
• Assess medical necessity and authorize waiver services.
• Evaluate benefits and advise on funding sources.
• Lead ICT meetings for service approvals/denials.
• Travel 25-40% as required based on state/contractual requirements.

Skills

Strong communication

Time management

Problem-solving

Self-motivation

Detail-oriented

Proactive

Relationship building

Microsoft Office

Mobility for travel

Education

Registered Nurse (RN) license

Bachelor's degree in healthcare (optional depending on state)

Tools

EHR systems

Microsoft Office

Job description

Molina Healthcare, Inc. is hiring a Care Manager RN to support LTSS care coordination across the care continuum.

You will work with a multidisciplinary team to assess needs, enroll waivers, develop and monitor care plans, and ensure quality outcomes for high-need members. The role requires at least 2 years in health care with a focus on care management, an active RN license, and willingness to travel locally (25-40%).