RN LTSS Care Manager: Impactful Care Coordination

Molina Healthcare; Worcester (MA); On-site; USD 85,962,000 - 169,059,000; Full time

Job summary

Molina Healthcare is hiring a Care Manager, LTSS (RN) in Worcester, MA. This role focuses on coordinating long-term services and supports, performing home assessments, and guiding waiver processes to improve member outcomes.

You will develop care plans with members and the care team, monitor progress, and ensure appropriate services are authorized and funded. A valid RN license and 2+ years in healthcare are required, with travel involved.

Qualifications

• Active and unrestricted RN license in state of practice.
• 2+ years healthcare experience; 1+ year in care/managed care.
• Experience with disabilities, chronic conditions, or substance use disorders.
• Valid driver’s license with reliable transportation.

Responsibilities

• Complete comprehensive member assessments within timelines, including in-person home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers and professionals.
• Monitor care plans for effectiveness and adjust as needed.
• Promote integration of services including behavioral health and LTSS.
• Assess medical necessity and authorize waiver services.
• Evaluate covered benefits and advise on funding sources.
• Lead interdisciplinary care team meetings for approvals/denials.
• Use motivational interviewing to educate and support members.
• Identify barriers to care and coordinate to address obstacles.
• Develop prevention plans for critical incidents.
• Conduct medication reconciliation as needed.
• Estimated 25-40% local travel may be required.

Skills

Care coordination

Interdisciplinary teamwork

Motivational interviewing

Assessments

Education

RN License - active

Bachelor’s degree in healthcare (optional)

Job description

Molina Healthcare is hiring a Care Manager, LTSS (RN) in Worcester, MA. This role focuses on coordinating long-term services and supports, performing home assessments, and guiding waiver processes to improve member outcomes.

You will develop care plans with members and the care team, monitor progress, and ensure appropriate services are authorized and funded. A valid RN license and 2+ years in healthcare are required, with travel involved.