RN LTSS Care Manager: Care Coordination & Waiver

Molina Healthcare; Brockton (MA); Sur place; USD 70 000 - 90 000; Plein temps

Résumé du poste

Molina Healthcare in Massachusetts is seeking a registered nurse care manager to coordinate LTSS for high-need members. You will work with a multidisciplinary team to develop and monitor care plans, enroll and disenroll waivers, and promote integrated services to improve outcomes.

The role requires at least 2 years in health care with RN licensure, strong communication skills, and the ability to travel locally 25–40%.

Qualifications

• At least 2 years of health care experience, including 1 year in care management or managed care.
• RN with active license 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, and auto insurance for travel.
• Ability to operate proactively and demonstrate detail-oriented work.
• Experience with community resources and diverse populations.
• Proficiency with Microsoft Office or equivalent software.

Responsabilités

• 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 other health professionals.
• Monitor care plan effectiveness and document interventions and goals.
• Promote integration of services across behavioral health, LTSS, and home/community resources.
• Assess medical necessity and authorize waiver services.
• Evaluate benefits and advise on funding sources.
• Facilitate interdisciplinary care team meetings for approval/denial of services.
• Use motivational interviewing and Molina clinical guideposts during member contacts.
• Identify barriers to care and provide care coordination to address psycho/social, financial, and medical obstacles.
• Travel 25-40% may be required.

Connaissances

RN license

Care management

Communication skills

Time management

Self-motivation

Travel

Microsoft Office

Formation

Bachelor's degree in health care

Outils

Microsoft Office

Description du poste

Molina Healthcare in Massachusetts is seeking a registered nurse care manager to coordinate LTSS for high-need members. You will work with a multidisciplinary team to develop and monitor care plans, enroll and disenroll waivers, and promote integrated services to improve outcomes.

The role requires at least 2 years in health care with RN licensure, strong communication skills, and the ability to travel locally 25–40%.