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2h ago Curated

Care Manager, LTSS (RN) Remote (Detroit MI)

Molina Healthcare

Job description

This RN acts as a Care Coordinator (Long Term Care Services) supporting Medicaid and Medicare dual members. The role involves phone outreach and in-person home visits to ensure members' long-term services and support needs are met. Duties include comprehensive member assessments, waiver enrollment/disenrollment, care plan development and monitoring, integration of behavioral health and LTSS services, assessing medical necessity for waiver services, and facilitating interdisciplinary care team meetings. Requires 2+ years healthcare experience including 1 year in care management/managed care and 1 year with LTSS populations. Must have active Michigan RN license, valid driver's license, and reliable transportation. Travel in Macomb and Wayne County is required (25-40% estimated).

Key responsibilities

  • Complete comprehensive member assessments via in-person home visits
  • Facilitate waiver enrollment and disenrollment processes
  • Develop and implement care plans in collaboration with members and providers
  • Monitor care plan effectiveness and document goal achievement
  • Promote integration of behavioral health and LTSS services
  • Assess medical necessity and authorize waiver services
  • Facilitate interdisciplinary care team meetings
  • Use motivational interviewing to support member behavior change
  • Identify barriers to care and coordinate resources
  • Conduct medication reconciliation as needed

What you bring

  • Active Michigan RN license
  • 2+ years healthcare experience
  • 1+ year care management/managed care experience
  • 1+ year experience with LTSS populations
  • Valid driver's license and reliable transportation
  • Proficiency in Microsoft Office
  • Strong communication and problem-solving skills

Tags

Remote with field travelLTSSCase ManagementMedicaid/MedicareMichigan

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