Care Manager, LTSS (Registered Nurse)

Job Summary As a Care Manager, you will play a vital role in supporting our members with long-term services and supports (LTSS). You'll collaborate with a multidisciplinary team to ensure comprehensive care coordination that meets the diverse needs of our members with high-need potential, contributing to effective and quality care delivery. Essential Job Duties Conduct thorough assessments of members, including in-person home visits, within established timelines. Facilitate enrollment and disenrollment in waiver programs. Develop and implement personalized care plans in collaboration with members, caregivers, and healthcare professionals. Monitor care plans continuously to evaluate effectiveness, document interventions, and suggest necessary adjustments. Integrate services, including behavioral health care and community resources, to ensure continuity of care. Assess medical necessity and authorize appropriate waiver services. Evaluate covered benefits and provide guidance on funding sources. Lead interdisciplinary care team meetings for service approvals and foster informal collaboration. Utilize motivational interviewing techniques to educate and support members in making positive changes. Identify barriers to care and assist members in overcoming psychosocial, financial, and medical challenges. Recognize critical incidents and create prevention plans to protect member health and welfare. Provide consultation and resources to peers when necessary. Handle complex member cases and medication regimens as needed. Perform medication reconciliation when required. Be prepared for local travel, estimated at 25-40% (dependent on state/funding requirements). Required Qualifications Minimum of 2 years of healthcare experience, with at least 1 year in care management or a medical/behavioral health setting, and 1 year working with individuals with disabilities or chronic conditions. Current, active, and unrestricted Registered Nurse (RN) license in the state of practice. Valid driver's license, reliable transportation, and appropriate auto insurance for travel. Detail-oriented with a proactive approach to work. Strong understanding of community resources available to members. Adaptability to work with diverse populations in various settings. Ability to work independently and maintain motivation with minimal supervision. Excellent communication and organizational skills to manage multiple priorities simultaneously. Proficiency in Microsoft Office suite and other relevant software. Preferred Qualifications Certified Case Manager (CCM) credential. Experience with populations receiving waiver services. Molina Healthcare offers a competitive benefits and compensation package. We are an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $26.41 - $51.49 / HOURLY. Actual compensation may vary based on geographic location, work experience, education and/or skill level.

Created: 2026-03-04