RN LTSS Care Manager & Waiver Services Lead

Molina Healthcare, Inc.; Cincinnati (OH); On-site; USD 70,000 - 95,000; Full time

Job summary

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

The role involves collaborating with a multidisciplinary team to deliver integrated member care and ensure progress toward outcomes, while aligning with the broader strategy for quality and cost-effective care. The position requires strong assessment, care planning, and coordination skills, plus the ability to travel locally up to 40% and work across diverse settings to

Qualifications

• At least 2 years of healthcare experience, including 1 year in care management or LTSS.
• RN license active and unrestricted in state of practice.
• Bachelor's degree in a health care field may be required in some states.
• Valid driver's license and reliable transportation for travel.
• Able to work independently, manage multiple tasks, and stay calm under pressure.
• Strong knowledge of community resources and ability to coordinate care across settings.
• Experience with populations with disabilities or chronic conditions is preferred.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians and team.
• Monitor care plan effectiveness, document interventions and outcomes, adjust as needed.
• Promote integration of LTSS and behavioral health services and link to community resources.
• Assess medical necessity and authorize waiver services.
• Coordinate ICT meetings for approvals/denials of services; collaborate with the team.
• Use motivational interviewing and Molina guides to educate and support change.
• Identify barriers to care and arrange psychosocial, financial, and medical support.
• Identify critical incidents and develop prevention plans; provide peer consultation when needed.
• Care manager RNs may handle complex cases and medication reconciliation as required.
• Travel 25-40% locally according to state/contractual requirements.

Skills

Communication

Time management

Detail oriented

Self-motivated

Independent worker

Proactive

Microsoft Office

Education

Registered Nurse (RN) license active

Bachelor's degree in health care field (state dependent)

Certified Case Manager (CCM) - preferred

Tools

Microsoft Office

Job description

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

The role involves collaborating with a multidisciplinary team to deliver integrated member care and ensure progress toward outcomes, while aligning with the broader strategy for quality and cost-effective care. The position requires strong assessment, care planning, and coordination skills, plus the ability to travel locally up to 40% and work across diverse settings to