RN LTSS Care Manager - Coordinate High-Need Member Care

Molina Healthcare, Inc.; Wilmington (OH); In loco; USD 36.000 - 71.000; Tempo pieno

Descrizione del lavoro

Molina Healthcare, Inc. seeks an experienced Registered Nurse to provide care management and LTSS coordination for high-need members.

You will collaborate with a multidisciplinary team to assess, plan, implement, and monitor member care across the continuum, aiming for quality outcomes and cost-effective services. Responsibilities include comprehensive assessments, waiver enrollment, care plan development, monitoring, and coordination with providers and families.

Competenze

• Active RN license in state of practice.
• 2+ years healthcare experience with LTSS or related fields.
• Experience with disabilities, chronic conditions, substance use disorders.
• Proactive, detail-oriented and self-motivated.
• Must have valid driver's license and transportation for travel.

Mansioni

• Complete comprehensive member assessments within required timelines, including home visits.
• Facilitate waiver enrollment/disenrollment processes.
• Develop and implement care plans with member, caregivers, physicians and team.
• Monitor care plan effectiveness and document interventions.
• Promote integration of services across LTSS and behavioral health.
• Assess medical necessity and authorize waiver services.
• Collaborate in ICT meetings for approval/denial of services.
• Educate and support members using motivational interviewing and clinical guidelines.
• Identify barriers and assist with psycho/social, financial, and medical needs.
• Identify critical incidents and develop prevention plans.
• May provide consultation to peers; complex cases may be assigned.

Conoscenze

Strong communication skills

Time management

Problem solving

Detail oriented

Self-motivation

Driver's license

Formazione

Registered Nurse (RN) license

Bachelor's degree in healthcare

Strumenti

Microsoft Office

Descrizione del lavoro

Molina Healthcare, Inc. seeks an experienced Registered Nurse to provide care management and LTSS coordination for high-need members.

You will collaborate with a multidisciplinary team to assess, plan, implement, and monitor member care across the continuum, aiming for quality outcomes and cost-effective services. Responsibilities include comprehensive assessments, waiver enrollment, care plan development, monitoring, and coordination with providers and families.