RN LTSS Care Manager: Integrated, Member-Centered Care

IntelliResume; Cincinnati, Long Beach (OH, CA); On-site; USD 54,000 - 106,000; Full time

Job summary

Molina Healthcare is seeking a Care Manager, LTSS (RN) in Cincinnati to coordinate long-term services and supports for members. You will assess needs, develop care plans, and collaborate with a multidisciplinary team to ensure high-quality care.

Active RN license is required, with potential state-specific bachelor’s degree requirements. The role emphasizes waiver enrollment, medical necessity reviews, and ongoing monitoring to optimize outcomes for individuals with complex needs.

Qualifications

• Active and unrestricted RN license in the state of practice.
• Bachelor's degree in a health care related field may be required in some states.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement care plans in collaboration with members, caregivers, and healthcare professionals.
• Perform ongoing monitoring of care plans to evaluate effectiveness and suggest changes.
• Promote integration of services for members, including behavioral health care and community resources.
• Assess for medical necessity and authorize appropriate waiver services.
• Evaluate covered benefits and advise on funding sources.
• Facilitate interdisciplinary care team meetings for service approval or denial.
• Use motivational interviewing to educate and support members.
• Assess for barriers to care and provide coordination to address concerns.

Skills

RN license

Care management

Motivational interviewing

Interdisciplinary collaboration

Waiver enrollment

Medical necessity assessment

Education

Bachelor's degree in health care related field

Job description

Molina Healthcare is seeking a Care Manager, LTSS (RN) in Cincinnati to coordinate long-term services and supports for members. You will assess needs, develop care plans, and collaborate with a multidisciplinary team to ensure high-quality care.

Active RN license is required, with potential state-specific bachelor’s degree requirements. The role emphasizes waiver enrollment, medical necessity reviews, and ongoing monitoring to optimize outcomes for individuals with complex needs.