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Case Manager, LTSS

2 months ago


Long Beach, California, United States Molina Healthcare Full time
Job Title: Case Manager, LTSS

Molina Healthcare Services (HCS) is seeking a skilled Registered Nurse (RN) to join our team as a Case Manager, Long Term Services and Supports (LTSS). This is a challenging and rewarding role that requires strong clinical skills, excellent communication, and a passion for delivering high-quality care to our Medicaid population.

Job Summary

The Case Manager, LTSS will work in a remote and field setting, supporting our Medicaid population with complex medical conditions and medication regimens. This role requires strong assessment and planning skills, as well as the ability to work effectively with interdisciplinary care teams to develop and implement individualized care plans.

Key Responsibilities
  • Conduct face-to-face comprehensive assessments of members per regulated timelines
  • Develop and implement a case management plan, including a waiver service plan, in collaboration with the member, caregiver, physician, and/or other appropriate healthcare professionals
  • Perform ongoing monitoring of the care plan to evaluate effectiveness, document interventions, and suggest changes accordingly
  • Assess for medical necessity and authorize all appropriate waiver services
  • Conduct face-to-face or home visits as required
  • Facilitate interdisciplinary care team meetings for approval or denial of services and informal ICT collaboration
Requirements
  • Graduate from an Accredited School of Nursing
  • At least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports
  • 1-3 years in case management, disease management, managed care, or medical or behavioral health settings
  • Active, unrestricted State Registered Nursing license (RN) in good standing
Preferred Qualifications
  • Bachelor's Degree in Nursing
  • 3-5 years in case management, disease management, managed care, or medical or behavioral health settings
  • 1 year experience working with population who receive waiver services
  • Active and unrestricted Certified Case Manager (CCM)
About Molina Healthcare

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. We offer a competitive benefits and compensation package to our employees. If you are interested in applying for this position, please apply through the intranet job listing.