Care Manager, LTSS (RN)

apartment Molina Healthcare location_onToledo, OH, US

JOB DESCRIPTION Job Summary

Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member 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 a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• May provide consultation, resources and recommendations to peers as needed.
• Care manager RNs may be assigned complex member cases and medication regimens.
• Care manager RNs may conduct medication reconciliation as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 2 years experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Ability to operate proactively and demonstrate detail-oriented work.
• Demonstrated knowledge of community resources.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations and various personalities and personal situations.
• Ability to work independently, with minimal supervision and demonstrate self-motivation.
• Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
• In some states, must have at least one year of experience working directly with individuals with substance use disorders.

Preferred Qualifications

• Certified Case Manager (CCM).
• Experience working with populations that receive waiver services.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Share this job

Related Jobs

Per Diem

Registered Nurse (RN)

apartment IntelyCare location_onOak Harbor, OH

$38 - $71 / hour

Earn up to $71 an hour as a Registered Nurse (RN) in Oak Harbor, OH (and surrounding areas), with a fully flexible schedule and a real work-life balance that you control. IntelyCare is replacing the old approach to nurse staffing with one that lets you prioritize your needs. On our team you get to pick the shifts at our partnering facilities that work best for you — and take time off on any day, week, or even month of your choosing. But that's not all; as a W2 company we also offer workplace benefits, career development opportunities, and a supportive team that's dedicated to your success. With a job that works around your life, you can enjoy more community events like the annual Oak Harbor Apple Festival or the Ottawa County Fair. You can also block out time for things you enjoy like morning dog walks down to Veterans Memorial Park. Whatever your choose to prioritize, IntelyCare offers a job that finally supports your life (not the other way around). If you appreciate flexibility along with a fulfilling career, then take a look at all the other competitive benefits and perks we offer below and consider joining our team today. Benefits RN hourly rate between $38 and $71 Get paid rates that are up to 25% higher on average, with weekly and daily pay options Opportunities for overtime as well as boosted rates for holidays Quickly find shifts in all states where you're authorized to practice Set your own schedule by selecting only your preferred shifts at any of our partner facilities Choose from weekday/weekend shifts, day/evening/overnight shifts, and more 401k retirement plan Upskilling opportunities with a dedicated team of quality assurance nursing professionals Eligibility for medical, dental, and vision insurance for you and qualifying family members Employer tax withholding each pay period Employer coverage for workers' comp and malpractice insurance Undergraduate and graduate tuition discounts at Excelsior University (up to 34%) Manage your shifts and access workplace perks like free continuing education courses through an all-in-one app At IntelyCare, you get a job and a schedule that you manage, but also a supportive community that has your back. Here's how some of our own nursing professionals have described the experience: "I love working with IntelyCare because of all the perks and benefits it provides. There are a variety of facilities to choose from in the app. At first I was going to multiple facilities until I found my two favorites, where I now work full time. I love it!" "I love how flexible this job is! I am a busy mom, so accepting last minute ‘hero’ shifts typically works out better than scheduling shifts in advance. I appreciate the pay and the additional bonuses." "IntelyCare has exceptionally high rates, a variety of facilities, and an easy and fun app to use. The staff here are all very personable and knowledgeable as well, which makes things so much easier. This is truly a 5-star agency." "I love IntelyCare because everything has been easy from the application process until now. There has never been a question unanswered, and everyone is always happy to help with whatever I needed. They always advocate on our behalf. I am so grateful to be an IntelyPro." Job Responsibilities Providing resident-focused, high-quality care while working as a RN in post-acute facilities Developing individualized care plans for residents in coordination with the wider medical team Reviewing care options with clinicians, nursing staff, residents, and their family members Setting up and using medical equipment and devices as needed for effective care Administering medications and providing treatments to residents consistent with their care plan Measuring and monitoring resident vital signs and drawing fluids as needed for labs and testing Ensuring accurate documentation of relevant information such as interventions and responses, vital signs, and resident medical histories Training and supervising nursing professionals and support staff as needed, consistent with scope of practice limitations Supporting staff with incident investigations and reporting Being accountable to follow and adhere to resident care plans Delivering care consistent with all applicable laws, policies, and standards of care Qualifications and Skills Current Ohio state license to practice as a Registered Nurse (RN) 6 months of experience (in an RN or related role) Completion of an approved nursing program High level of organizational skills Demonstrated ability to effectively communicate across medical and nursing teams Ability to lift at least 50 lbs Get the Flexibility You Need and the Support You Deserve As you compare Registered Nurse (RN) jobs in your area, consider joining a company that was created with professionals like you in mind. Get the work-life balance and peace of mind you deserve by joining the team ranked #1 in quality today. COVID-19 Considerations: COVID-19 vaccination requirements vary by state. We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Location: Oak Harbor, Ohio 43449

Full-time

RN / Surgery / Full Time

apartment Wood County Hospital location_onBowling Green, OH

Elevate your career at Wood County Hospital, where you're not just a number – you're a vital part of a team making a real difference. RN / Surgery / Full Time Provides personal care and professional excellence through activities of evidenced based practice in areas such as assessment, collaboration, patient education, and responsiveness under the scope of practice as outlined by Ohio State Board of Nursing. Registered Nurse is an onsite position. Job Duties: Assess, plan, implement, and evaluate nursing care provided to patients. Maintain accurate, timely, detailed reports and records. Individualize care based on patient values, preferences, and needs. Collaborate and advocate with other health care providers to provide best outcome for patients. Educate patient and family from admission to discharge considering patient and family comprehension and style of learning. Prepare, prevent, protect and respond to support our culture of safety. Works hours per week in accordance with offer letter or per attributes of position at transfer request. May be expected to work longer hours as necessary. Other duties as assigned. Minimum Requirements: Education Diploma Nurse or ADN from an accredited school of nursing, License Ohio Registered Nurse by time of hire Certification BLS and ACLS within 90 days of hire (All Acute Nursing Units) PALS within 90 days of hire (ED, PACU, Infusion) NRP within 90 days of hire (OB) Benefit Summary: Join our team, and you’ll have access to a cutting-edge facility with state-of-the-art technology. You’ll also interact with some of the region's top notch healthcare professionals. You’ll find plenty of opportunities to grow and advance your career. We’ll also reward your hard work with: Great health, dental and vision plans Competitive wages Prescription drug coverage Flexible spending accounts Life insurance w/AD&D Generous short term and long-term disability plans Employer-matched 403(b) Employer sponsored cash balance pension plan Vacation and Holiday time Generous tuition reimbursement And a lot more!

Per Diem

RN / Emergency Department / Per Diem

apartment Wood County Hospital location_onBowling Green, OH

Elevate your career at Wood County Hospital, where you're not just a number – you're a vital part of a team making a real difference. RN Emergency Department, Per Diem Provides personal care and professional excellence through activities of evidenced based practice in areas such as assessment, collaboration, patient education, and responsiveness under the scope of practice as outlined by Ohio State Board of Nursing. Registered Nurse is an onsite position. Major Tasks, Duties and Responsibilities: 1. Assess, plan, implement, and evaluate nursing care provided to patients. 2. Maintain accurate, timely, detailed reports and records. 3. Individualize care based on patient values, preferences, and needs. 4. Collaborate and advocate with other health care providers to provide best outcome for patients. 5. Educate patient and family from admission to discharge considering patient and family comprehension and style of learning. 6. Prepare, prevent, protect and respond to support our culture of safety. 7. Works hours per week in accordance with offer letter or per attributes of position at transfer request. May be expected to work longer hours as necessary. 8. Other duties as assigned. Requirements Education: Diploma Nurse or ADN from an accredited school of nursing License: Registered Nurse in the State of Ohio by time of hire Experience: None Certification: BLS and ACLS within 90 days of hire PALS required within 90 days of hire (ED, PACU, Infusion) NRP within 90 days of hire (OB) Benefit Summary: Join our team, and you’ll have access to a cutting-edge facility with state-of-the-art technology. You’ll also interact with some of the region's top notch healthcare professionals. You’ll find plenty of opportunities to grow and advance your career. We’ll also reward your hard work with: Great health, dental and vision plans Competitive wages Prescription drug coverage Flexible spending accounts Life insurance w/AD&D Generous short term and long-term disability plans Employer-matched 403(b) Employer sponsored cash balance pension plan. Vacation and Holiday time. Generous tuition reimbursement And a lot more!

Per Diem

Registered Nurse (RN)

apartment IntelyCare location_onBowling Green, OH

$38 - $71 / hour

Advance your career and earn up to $71 an hour as a Registered Nurse (RN) in Bowling Green, Ohio (and throughout the greater Toledo area), while enjoying the benefit of flexible schedules. At IntelyCare, we know that nursing professionals appreciate balanced lives and professional support, which is why we hire our staff as W2 employees (with benefits) and also offer the freedom to choose the shifts at our partner facilities that make the most sense for you. With a healthy work-life balance, you can achieve your career goals and still have a full life outside of scrubs. Do you prefer early shifts so you can unwind and recuperate in the lush surroundings of Simpson Garden Park? Want to carve out some time to sell your homemade soaps at the Bowling Green Farmer's Market during peak hours? At IntelyCare, you don't have to compromise. Take a look at everything we offer and decide whether becoming an IntelyPro is the right move for you. Benefits RN hourly rate between $38 and $71 Get paid rates that are up to 25% higher on average, with weekly and daily pay options Opportunities for overtime as well as boosted rates for holidays Quickly find shifts in all states where you're authorized to practice Set your own schedule by selecting only your preferred shifts at any of our partner facilities Choose from weekday/weekend shifts, day/evening/overnight shifts, and more 401k retirement plan Upskilling opportunities with a dedicated team of quality assurance nursing professionals Eligibility for medical, dental, and vision insurance for you and qualifying family members Employer tax withholding each pay period Employer coverage for workers' comp and malpractice insurance Undergraduate and graduate tuition discounts at Excelsior University (up to 34%) Manage your shifts and access workplace perks like free continuing education courses through an all-in-one app Want to know what it's like to work for IntelyCare — straight from the source? Here are some reviews from a few of our "IntelyPros" to give you a sense of what it's like to be a part of our team: "IntelyCare is 10/10! I have worked with them for a little over two years and I have never been disappointed. The customer service staff takes care of everything you need in a very timely manner." "IntelyCare works with us, not against us! I have been feeling the support from the moment I started. Everyone here is willing to help you achieve your goals, and for that to happen you don’t necessarily have to be a full-time employee." "Since I joined IntelyCare, I have been stress-free! I make my own schedule, I get to spend more time with my family, and make enough to cover my expenses." "I love IntelyCare because it is extremely convenient and reliable. This job alone has saved me from being in debt and is keeping a roof over my head…There are so many benefits from being an IntelyPro: a good retirement plan, health insurance, shift variety, and a team that actually cares about you. I love being an IntelyPro!" Job Responsibilities Providing high-quality RN care in post-acute facilities Reviewing various care options with the medical team, residents, and their family members Coordinating with clinical teams to develop individualized care plans Being accountable to follow and adhere to resident care plans Administering appropriate medications and treatments to residents Drawing fluids as needed for labs and testing Using and monitoring medical equipment and devices to ensure effectiveness Training and supervising nursing professionals and other care staff consistent with scope of practice guidelines Promoting staff compliance with all applicable laws, regulations, facility policies, and nursing standards of care Documenting all relevant data to include vital signs, nursing interventions and responses, and resident histories Assisting staff members with incident investigations and the development of care best practices Qualifications and Skills Current Ohio state license to practice as a Registered Nurse (RN) Successful completion of an approved nursing program Minimum of 6 months of experience ( RN or related role) Advanced skills in multitasking, organization, and communication Ability to lift a minimum of 50 lbs Get the Flexibility You Need and the Support You Deserve As you compare Registered Nurse (RN) jobs in your area, consider joining a company that was created with professionals like you in mind. Get the work-life balance and peace of mind you deserve by joining the team ranked #1 in quality today. COVID-19 Considerations: COVID-19 vaccination requirements vary by state. We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Location: Bowling Green, Ohio 43402

Home Health

Full-time

Registered Nurse RN Home Health

apartment Elara Caring location_onMonroe, MI

At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here, each employee has the chance to make a real difference by carrying out our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right Time, in the Right Place. Job Description: Registered Nurse Home Health At Elara Caring, we care where you are and believe the best place for your care is where you live. We know there’s no place like home, and that’s why our teams continue to provide high-quality care to more than 60,000 patients each day in their preferred home setting. Wherever our patients call home and wherever they are on their health journey, we care. Each team member has a part to play in this mission. This means you have countless ways to make a difference as a Registered Nurse Home Health. Being a part of something this great, starts by carrying out our mission every day through your true calling: developing an amazing team of compassionate and dedicated healthcare providers. To continue to be an industry pioneer delivering unparalleled care, we need a Registered Nurse Home Health with commitment and compassion. Are you one of them? If so, apply today! Why Join the Elara Caring mission? Work autonomy and flexible schedules 1:1 patient care Supportive and collaborative environment Competitive compensation package Tuition reimbursement for full-time staff and continuing education opportunities for all employees Comprehensive insurance plans for medical, dental, and vision benefits 401(K) with employer match Paid time off, paid holidays, family and pet bereavement Pet insurance As a Registered Nurse Home Health, you’ll contribute to our success in the following ways: Ensures that all activities performed align with the vision of Elara Caring’s board of directors, executive team, and the leadership of the Home Health team. Add key accountabilities here. Maintains patient and staff privacy and confidentiality pursuant to HIPAA Privacy Final Rule. Assesses assigned case load of home health care patients and families to identify the physical, psychosocial, and environmental needs of patients as evidenced by documentation, clinical records, Interdisciplinary Team reports, after hours reports, and on-site evaluations. Assumes primary responsibility for caseload, including assessing, planning, coordinating, implementing, and evaluating the plan of treatment. Assesses patient needs and obtains data on physical, psychological, social, and spiritual factors that may influence patient/family/caregiver health status and incorporate that data into the plan of care. Makes the initial evaluation and re-evaluates the patient’s nursing needs during each visit. Makes follow up visits according to patient, family, and facility needs. Communicates significant findings, problems, and changes in health condition, environment, or unsafe facility conditions to the Clinical Supervisor, physician, facility, and/or other personnel involved with patient care. Revises the plan of care in response to identified patient care issues and notifies the Clinical Supervisor, physician, facility, and other team members. What is Required? Current, unrestricted state RN licensee 1+ year experience in a clinical care setting as a nurse Able and willing to travel within branch/office coverage area. Must have a dependable vehicle, valid driver’s license, and current auto insurance in accordance with state laws. Must be able and willing to travel 50% Associates Degree or Bachelor’s Degree in Nursing is preferred Previous Home Health or Hospice Experience is preferred Previous experience with HomeCare HomeBase is preferred You will report to the Clinical Manager or Clinical Supervisor This is not a comprehensive list of all job responsibilities and requirements; a full job description will be provided upon request. We value the unique skills of veterans and military spouses. We encourage applications from military veterans and their families. Elara Caring provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to sex (including pregnancy, childbirth or related medical conditions), race, color, age (40 and older), national origin, religion, disability, genetic information, marital status, sexual orientation, gender identity, gender reassignment, protected veteran status, or any other basis prohibited under applicable federal, state or local law. Elara Caring participates in E-Verify and we will provide the Federal Government with your Form I-9 information to confirm that you are authorized to work in the United States. Employers like Elara Caring can only use E-Verify once you have accepted the job offer and completed the Form I-9. At Elara Caring, pay and compensation are determined by a variety of factors, including education, job-related knowledge, skills, training, and experience. Our compensation structure reflects the cost of labor across different U.S. geographic markets, and may vary based on location. This is not a comprehensive list of all job responsibilities and requirements; upon request, a job description can be provided. If you are an individual with a disability and are unable or limited in your ability to use or access our career site as a result of your disability, you may request reasonable accommodations by reaching out to recruiting@elara.com.