RN LTSS Care Manager - Home & Community Care

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

Job summary

Molina Healthcare, Inc. is seeking a Care Manager RN to support LTSS care coordination across multiple counties in Ohio. You will collaborate with an interdisciplinary team to ensure high-need members receive integrated care and reach desired outcomes.

The role requires at least 2 years in health care, an active RN license, and experience with waiver processes, LTSS, and behavioral health. Some travel is expected (25-40%).

Qualifications

• At least 2 years of experience in health care, including 1 year in care management or managed care.
• Experience with persons with disabilities, chronic conditions, LTSS, or substance use disorders preferred.
• RN license must be active and unrestricted in state of practice.
• Ability to operate proactively and manage multiple tasks.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians and care team.
• Monitors care plan effectiveness, documents interventions and suggests changes.
• Promotes integration of LTSS with behavioral health and community resources.
• Assesses medical necessity and authorizes waiver services.
• Coordinates ICT meetings for approval/denial of services.
• Travel may be required 25-40% depending on state/contractual requirements.

Skills

Care management

Effective communication

Time management

Problem solving

Self-motivation

Independence

Education

Registered Nurse (RN) license

Bachelor's degree in a health care related field

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. is seeking a Care Manager RN to support LTSS care coordination across multiple counties in Ohio. You will collaborate with an interdisciplinary team to ensure high-need members receive integrated care and reach desired outcomes.

The role requires at least 2 years in health care, an active RN license, and experience with waiver processes, LTSS, and behavioral health. Some travel is expected (25-40%).