Join to apply for the RN Care Manager - Waiver Program role at Molina Healthcare
For this position we are seeking a Registered Nurse who lives in Ohio and must be licensed for the state of Ohio.
This role supports our Medicaid/Medicare Population (MMP) with members on the Waiver program. The RN will manage a case load of members enrolled in this program, providing care coordination, case management, and field visits to members’ homes. The position requires field work with assessments and member visits in the surrounding areas (travel reimbursed). The schedule is Monday‑Friday 8:00 AM to 5:00 PM EST (no weekends or holidays).
Job Summary
Provides support for care management/care coordination, long‑term services and supports. The RN collaborates with a multidisciplinary team to coordinate integrated delivery of member care across the continuum, ensuring member progress toward desired outcomes and contributing to overall strategy for quality and cost‑effective care.
Essential Job Duties
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, including waiver service plans, in collaboration with members, caregivers, physicians, and other health‑care professionals.
Performs ongoing monitoring of care plans to evaluate effectiveness, document interventions and goal achievement, and suggest changes as needed.
Promotes integration of services including behavioral health and long‑term services and supports (LTSS) to enhance continuity of care.
Assesses medical necessity and authorizes appropriate waiver services.
Evaluates covered benefits and advises on funding sources.
Facilitates interdisciplinary care team meetings for service approval or denial and informal collaboration.
Uses motivational interviewing and Molina clinical guideposts to educate, support, and motivate change during member contacts.
Assesses barriers to care and provides coordination to address psychosocial, financial, and medical obstacles.
Identifies critical incidents and develops prevention plans to ensure member health and welfare.
May provide consultation, resources, and recommendations to peers as needed.
May conduct medication reconciliation and manage complex member cases and medication regimens.
Estimated 25‑40% local travel may be required.
Required Qualifications
At least 2 years of health‑care experience, including 1 year in care management or a medical/behavioral health setting, and at least 1 year working with individuals with disabilities, chronic conditions, substance use disorders, or LTSS.
Registered Nurse (RN) with an active, unrestricted license in Ohio.
Valid and unrestricted driver’s license and reliable transportation for travel.
Detail‑oriented, proactive, and able to work independently with minimal supervision.
Knowledge of community resources and strong communication skills.
Ability to stay calm in high‑pressure situations and manage multiple projects.
Proficiency in Microsoft Office and related software.
Preferred Qualifications
Certified Case Manager (CCM).
Experience working with populations receiving waiver services.
Compensation: Pay Range – $26.41 - $51.49 / HOURLY (actual compensation may vary based on experience, qualifications, and geographic location).
Molina Healthcare offers a competitive benefits and compensation package.
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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