RN LTSS Care Navigator & Care Coordination Lead

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

Job summary

Molina Healthcare, Inc. is seeking a Registered Nurse-led Care Manager to support care management and coordination for LTSS members in Ohio.

The role collaborates with a multidisciplinary team to ensure quality, cost-effective care and adherence to regulatory timelines, including home visits when required. Responsibilities include developing tailored care plans with members and caregivers, monitoring plan effectiveness, and facilitating waiver services.

Qualifications

• Active RN license in state of practice.
• Minimum 2 years in health care with 1 year in care management or LTSS.
• Experience with persons with disabilities, chronic conditions, substance use disorders preferred.

Responsibilities

• Complete comprehensive member assessments within timelines, including in-person visits as required.
• Facilitate waiver enrollment/disenrollment processes.
• Develop and implement care plans with members and care network.
• Monitor and adjust care plans based on outcomes and barriers.
• Coordinate services across behavioral health and LTSS for continuity of care.
• Assess medical necessity and authorize waiver services.
• Conduct ICT meetings for service decisions.

Skills

Communication

Time management

Detail-oriented

Self-motivation

Education

RN License (active)

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. is seeking a Registered Nurse-led Care Manager to support care management and coordination for LTSS members in Ohio.

The role collaborates with a multidisciplinary team to ensure quality, cost-effective care and adherence to regulatory timelines, including home visits when required. Responsibilities include developing tailored care plans with members and caregivers, monitoring plan effectiveness, and facilitating waiver services.