Long-Term Services and Supports Care Manager (RN) in Lehi, UT

Job Summary As a Long-Term Services and Supports Care Manager, you will play a crucial role in providing high-quality care coordination and management for members with complex needs. You will collaborate with a multidisciplinary team to ensure integrated delivery of care, helping members progress toward their desired outcomes while driving strategies for effective and cost-efficient care. Essential Job Duties • Conduct comprehensive member assessments, including necessary in-home visits within regulated timelines. • Facilitate the waiver enrollment and disenrollment process effectively. • Develop and implement care plans in collaboration with members, caregivers, healthcare professionals, and the member support network. • Monitor ongoing care plans, documenting interventions and goal achievements, and suggesting necessary updates. • Promote service integration for members, considering behavioral health and community resources to ensure continuity of care. • Assess medical necessity and authorize appropriate waiver services. • Evaluate coverage options and provide guidance on funding sources. • Organize interdisciplinary care team meetings to discuss service approvals and facilitate collaboration. • Utilize motivational interviewing techniques and clinical guidelines to support and educate members. • Identify and address barriers to care, providing coordination to overcome psycho/social, financial, and medical challenges. • Recognize critical incidents and develop plans to ensure member health and safety. • Be prepared to provide consultation and recommendations to colleagues as needed. • Handle complex member cases and conduct medication reconciliations when necessary. • Anticipate local travel requirements of approximately 25-40%, depending on state regulations. Required Qualifications • Minimum of 2 years of healthcare experience, with at least 1 year in care management, managed care, or a medical/behavioral health setting. • Proven experience working with individuals with disabilities, chronic conditions, or substance abuse issues. • Active and unrestricted Registered Nurse (RN) license in your state. • Valid driver's license, reliable transportation, and adequat auto insurance for work-related travel. • Detail-oriented with the ability to operate proactively. • Strong knowledge of community resources and capacity to work with diverse populations. • Ability to work independently with minimal supervision. • Responsive communication skills and calmness under pressure. • Excellent time management, prioritization, problem-solving, and critical-thinking abilities. • Proficient in Microsoft Office suite and relevant software applications. • Experience working directly with individuals with substance use disorders is preferred in some states. Preferred Qualifications • Certified Case Manager (CCM) certification. • Experience working with populations that utilize waiver services. 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 per hour. Actual compensation may vary based on geographic location, work experience, education, and skill level.