RN LTSS Care Manager: Integrated, Outcome‑Driven Care

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

Job summary

Molina Healthcare, Inc. is seeking a RN Care Manager to support care management and coordination for LTSS.

You will collaborate with a multidisciplinary team to deliver integrated member care and work toward outcomes while aligning with strategy to provide cost-effective, quality care. Responsibilities include conducting comprehensive assessments, coordinating waiver processes, creating and monitoring care plans, facilitating team decisions, and addressing barriers to care.

Qualifications

• At least 2 years in health care with care management or LTSS experience.
• Active and unrestricted RN license in state of practice.
• Bachelor's degree in a health care related field may be required.
• Valid driver's license and reliable transportation for travel.
• Strong communication and organizational skills.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans in collaboration with members, caregivers, physicians and support network.
• Performs ongoing monitoring of care plan and documents interventions and outcomes.
• Promotes integration of services to enhance continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and funding sources and coordinates ICT meetings as needed.
• Uses motivational interviewing to educate and support change during member contacts.
• Addresses barriers to care and supports psycho/social, financial, and medical needs.
• Identifies incidents and develops prevention plans for member health.
• May provide consultation and resources to peers as needed.
• Care manager RNs may manage complex cases and conduct medication reconciliation.
• 25-40% estimated local travel may be required.

Skills

Care coordination

Communication skills

Problem solving

Microsoft Office

Independent work

Education

Registered Nurse (RN) license

Bachelor's degree in health care field

Job description

Molina Healthcare, Inc. is seeking a RN Care Manager to support care management and coordination for LTSS.

You will collaborate with a multidisciplinary team to deliver integrated member care and work toward outcomes while aligning with strategy to provide cost-effective, quality care. Responsibilities include conducting comprehensive assessments, coordinating waiver processes, creating and monitoring care plans, facilitating team decisions, and addressing barriers to care.