Care Manager - LTSS, RN
About the job
- At least 2 years of experience in health care, including at least 1 year of experience in care management, managed care, and/or 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 an equivalent combination of relevant education and experience.
- Registered Nurse (RN) license that is active and unrestricted in the state of practice.
- A valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job-related travel, unless otherwise required by law.
- Ability to work proactively and demonstrate attention to detail.
- Knowledge of community resources.
- Ability to work in a variety of settings and adjust approach when working with diverse populations and different 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.
- Time-management and prioritization skills, with ability to manage multiple projects and adapt to change.
- Problem-solving skills.
- Strong verbal and written communication skills.
- Proficiency with Microsoft Office suite or applicable software programs.
- In some states, at least one year of experience working directly with individuals with substance use disorders is required.
- Complete comprehensive member assessments within regulated timelines, including required in-person home visits.
- Facilitate comprehensive waiver enrollment and disenrollment processes.
- Develop and implement care plans, including waiver service plans, in collaboration with members, caregivers, physicians, other appropriate health care professionals, and member support networks to address member needs and goals.
- Monitor care plans on an ongoing basis to evaluate effectiveness, document interventions and goal achievement, and suggest changes as appropriate.
- Promote integration of services for members, including behavioral health care, LTSS, and home and community resources, to enhance continuity of care.
- Assess medical necessity and authorize appropriate waiver services.
- Evaluate covered benefits and advise on funding sources.
- Facilitate interdisciplinary care team (ICT) meetings for service approvals or denials and informal ICT collaboration.
- Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate change during member contacts.
- Assess barriers to care and provide care coordination and assistance to address members' psychosocial, financial, and medical obstacles.
- Identify critical incidents and develop prevention plans to assure member health and welfare.
- Provide consultation, resources, and recommendations to peers as needed.
- For care manager RNs, manage complex member cases and medication regimens as assigned, and conduct medication reconciliation as needed.
- Travel locally an estimated 25–40% of the time, as required by state or contractual requirements.
- Certified Case Manager (CCM).
- Experience working with populations that receive waiver services.
About the company
Molina Healthcare provides government-sponsored health plans in the United States, primarily serving low-income individuals and families through Medicaid, Medicare, and Marketplace products. It partners with state and federal governments to administer these programs and earns revenue from member premiums and payments for program management. A key differentiator is its focus on cost management and preventive care, aided by an online provider portal that lets clinicians verify eligibility, submit claims, and access resources. Its goal is to expand access to affordable, quality health coverage while delivering sustainable administration of government-backed plans.
Company Size
10,001+
Company Stage
IPO
Headquarters
Long Beach, California
Founded
1980
Get referred to Molina Healthcare
See people who can refer or advise you
Simplify's Take
What believers are saying
- July 22, 2026 adjusted EPS reached $1.51, and full-year guidance rose to $5.25.
- Medicaid drove first-half 2026 performance, and management lifted earnings guidance on July 22.
- Molina trimmed Marketplace exposure in 2026, targeting margins before 2027 enrollment resets.
What critics are saying
- Ohio will lose Molina Marketplace plans in 2027, cutting exchange presence.
- Second-quarter 2026 MCR hit 92.2%, crushing margins and cash generation.
- The September 2026 securities class action attacks guidance discipline and management credibility.
What makes Molina Healthcare unique
- Molina Healthcare specializes in Medicaid, Medicare, and Marketplace plans for low-income members.
- June 30, 2026, it served 4.9 million members across 21 states.
- Its local health plans combine care coordination, disease management, and government contracting expertise.
Help us improve and share your feedback! Did you find this helpful?
Benefits
Health Insurance
401(k) Retirement Plan
Remote Work Options
Paid Vacation
Flexible Work Hours
Wellness Program
Mental Health Support
Conference Attendance Budget
Professional Development Budget
Phone/Internet Stipend
Home Office Stipend
Family Planning Benefits
Fertility Treatment Support
Stock Options
Company Equity
Hybrid Work Options
PTO/vacation mention not explicit beyond Paid Vacation
Paid Sick Leave
Paid Holidays
Adoption Assistance
Company News
Caresource and Molina will leave Ohio ACA Marketplace plans in 2027, affecting about 54,000 residents across the state. * October 3, 2026 7:30 am Oct 2, 2026 DAYTON, OH - Two major health insurers will stop offering Affordable Care Act Marketplace plans in Ohio in 2027, changing coverage options for tens of thousands of residents who buy individual health insurance through the exchange. Dayton-based CareSource and Molina Healthcare of Ohio are both leaving the market, according to notices and statements from the companies and the Ohio Department of Insurance. The change affects a combined 54,000 Ohioans who currently get coverage through those insurers on the state's ACA Marketplace. CareSource said it made a difficult decision to exit the Ohio marketplace and will not offer the product in 2027. Current members will keep their coverage through Dec. 31, 2026. After that, they will need to choose a new plan during open enrollment for 2027. CareSource says rising costs pushed the exit. CareSource said the move was driven by higher health care costs and continuing changes in the ACA Marketplace. The nonprofit said it reviews its programs regularly to make sure they remain effective and financially sustainable. In its statement, the company said it remains focused on serving members and communities across Ohio. CareSource also said the decision does not affect its Medicaid or MyCare Ohio plans, which will continue operating. As of May, CareSource covered about 28,300 people through Ohio's ACA Marketplace, state officials said. The company offers health insurance products, including Medicaid, ACA Marketplace, and Medicare plans, to more than two million members across 12 states. Across its brands, CareSource reported more than $13 billion in revenue in 2024, with earnings above $386 million, according to nonprofit tax filings. Molina's Ohio members will also need new coverage. Molina Healthcare of Ohio did not respond to a request for comment, but its exit will also leave thousands of enrollees looking for another plan for 2027. The Ohio Department of Insurance said the company is part of the group of insurers leaving the exchange next year. Molina Healthcare Inc., the parent company of the Ohio subsidiary, is a publicly traded Fortune 500 company that provides managed health care services through Medicaid, Medicare and state insurance marketplaces. It serves about 5.5 million members in 21 states, according to the company's website. The company reported total revenue of about $10.9 billion for the three months ended June 30, 2026. Net income for the quarter was $60 million, down 76% from $255 million in the second quarter of 2025. Molina's earnings show pressure in the ACA business. Molina said lower premium revenue and a higher medical care ratio drove the decline in quarterly profits. The medical care ratio measures how much of a health insurer's premium income is spent on patient care and quality improvement. For the second quarter of 2026, Molina's consolidated medical care ratio was 92.2%. Its ACA Marketplace plans posted an 88.9% ratio, which the company said was still above its expectations for those plans. In its 2025 annual report, Molina said it brought in $45.4 billion in revenue, with net earnings of $472 million and a medical care ratio of 91.7%. The company said 2024 revenue was $40.7 billion, with net earnings of $1.2 billion and a medical care ratio of 89.1%. Open enrollment begins Nov. 1 for people shopping the exchange. The Affordable Care Act requires every state to have an exchange where people can buy individual health insurance policies. In Ohio, the federal government runs the exchange. Residents who do not have insurance through an employer, Medicare or Medicaid may be eligible to buy coverage through the marketplace. For 2027 coverage, open enrollment runs from Nov. 1 through Jan. 15, 2027, according to the Ohio Department of Insurance. People who want coverage starting Jan. 1, 2027, must enroll by Dec. 15. That deadline will matter for anyone whose current plan is ending after the 2026 plan year. More insurers will remain on the exchange across most Ohio counties. The Ohio Department of Insurance approved nine companies to sell plans on the exchange for 2027. Based on the department's approved plan information, only five counties will have two insurers available, while every other county will have at least three. In the Dayton, Springfield and Hamilton regions, counties will have between six and seven insurers offering plans. That means residents in much of the state will still have several options even after CareSource and Molina leave. Companies that have filed to sell individual plans in Ohio's ACA Marketplace include AmeriHealth Caritas Ohio, Antidote Health Plan of Ohio, Buckeye Community Health Plan, Community Insurance Company, Medical Mutual of Ohio, Oscar Buckeye State Insurance Corporation, Oscar Insurance Corporation of Ohio, Summa Insurance Company and United Healthcare of Ohio. Live weather alerts and forecasts from JM Rocket Reporter.
Press release: The Molina Healthcare Charitable Foundation awards $15,000 grant to Ozark Center for Behavioral Health training in southwest Missouri schools. On: September 23, 2026 The Molina Healthcare Charitable Foundation ("MolinaCares"), in collaboration with Molina Healthcare of Missouri ("Molina"), awarded a $15,000 grant to the Ozark Center, an entity of Freeman Health System, to launch the Rural Behavioral Health Rapid Access and Transition Coordination Pilot. The grant will fund training for school staff, educational resources for families, and stronger referral pathways in rural school districts in the Joplin area. "Access to behavioral healthcare is limited in rural communities, and schools are often on the front lines of identifying students in need," said Vicky Mieseler, chief executive officer at Ozark Center. "With Molina's funding, we will train school staff in the Joplin area to recognize and respond to behavioral health challenges, provide families with practical information and referral resources, and connect students to support before concerns escalate to a crisis." Grant funds will pay for behavioral health awareness and early identification training for teachers, counselors, administrators, and school nurses. It will also support printed and digital education materials, referral guides, and prevention resources for students and families as well as parent engagement and community awareness events. Ozark Center expects to train 50 to 100 school personnel directly and reach up to 2,000 students and their families indirectly. "Access to behavioral health resources is key to helping young people build resiliency, overcome challenges and stay in school," said Jay Ludlam, plan president of Molina Healthcare of Missouri. "By partnering with the Ozark Center, Molina is helping create a sustainable model that can strengthen school-based supports for Missouri youth in rural areas." Findings from the pilot, including training results and family engagement data, will be used to determine whether the model can be extended to additional districts.
Molina Healthcare of Michigan awards $20,000 in scholarships to UM-Flint and Mott Community College students to address shortages in healthcare fields. by Tanya September 18, 2026 158 FLINT, Mich., Sept. 17, 2026 - Molina Healthcare of Michigan ("Molina"), in partnership with University of Michigan-Flint ("UM-Flint") and Mott Community College, announced recipients of four scholarships awarded to students in the dental and social work programs in their respective schools. These particular healthcare fields are experiencing shortages throughout Michigan, particularly in traditionally underserved communities. The recipients are: * Brooklyn Daly, dental hygiene student, Mott Community College * Tasheikya Hunter, Master of Social Work student, UM-Flint * Mandi Villarreal, Master of Social Work student, UM-Flint * Stephanie Wooster, dental hygiene student, Mott Community College The winners were chosen, in part, based on their intention to remain in the state and practice in low-income areas where services are lacking. According to a report released in March by the Michigan State Medical Society, almost one-third of Michiganders lack access to primary care which can cause delays in treatment, poorer health outcomes and widening disparities. "This scholarship represents a transformative opportunity for Mott Community College's Dental Hygiene students," shared Shaunda Richardson-Snell, president of Mott Community College. "By supporting key program expenses, including specialized equipment and national board preparation, this generous gift helps clear the runway for our students to excel academically and step seamlessly into rewarding careers. We are incredibly grateful for the extraordinary support." "Molina's generous support reflects a shared commitment to building healthier, more resilient communities," said Shan Parker, dean of the University of Michigan-Flint College of Health Sciences. "By reducing financial barriers for our Master of Social Work students, these scholarships will help prepare the next generation of skilled, compassionate social workers to serve individuals and families throughout Flint and the region." "There is a correlation between community health and access to care, and these scholarships are investment in the future well-being of Michiganders by increasing the pool of practitioners," said Terrisca Des Jardin, plan president for Molina Healthcare of Michigan. "We congratulate the winners and look forward to the impact they will make in the lives of those they serve in the years to come." About Molina Healthcare of Michigan Molina Healthcare of Michigan, Inc. provides government-funded, quality health care, serving members through Medicaid, Medicare and Marketplace programs in Michigan. Through its locally operated health plans, Molina Healthcare, Inc., a Fortune 500 company, provides managed health care services under the Medicaid and Medicare programs, and through state insurance marketplaces. For more information about Molina Healthcare of Michigan, visit MolinaHealthcare.com.
From crisis to connection: building a network of care. The Spokane Complex Fires changed the way many of Excelsior Wellness experienced its community. For Excelsior Wellness, the fires directly impacted its Indian Trail location and temporarily changed how Excelsior Wellness served the people who rely on Excelsior Wellness. Under Level 3 evacuation orders, its team had to adapt quickly. What became clear in those days was that continuing to care for its community did not always mean doing things the way Excelsior Wellness normally do them. It meant finding another way. And Excelsior Wellness did that together. The Martin Luther King Jr. Community Center opened its doors so its summer camp youth could continue gathering safely while its buildings on Indian Trail were evacuated. The center also provided meals and snacks, helping create a sense of stability during an uncertain time. Meals on Wheels Spokane provided lunches for its young adults while they were displaced. At the same time, its grounds became a place where other organizations could do their work. Avista Utilities used its parking lot as a recovery hub while more than 30 trucks deployed further North on Indian Trail and into other impacted neighborhoods to help restore power and infrastructure. At the Shadle Park High School Disaster Recovery Hub, its team helped families connect with resources as they navigated displacement, the loss of their homes, insurance questions, evacuation orders, and the many challenges that follow a disaster. Excelsior Wellness partnered with Molina Healthcare to deploy its mobile clinic to the Yoke's Fresh Market on Indian Trail, providing primary and urgent care and helping community members replace medications lost or left behind during the fires. Then came another kind of response: neighbors helping neighbors. Through its partnership with Second Harvest, Excelsior Wellness launched the Community Care Hub and activated its Community Care Center to provide food, hygiene products, cleaning supplies, pet food, and other essential items. Charlie's Produce stepped forward with additional donations after learning about the effort. Community members brought donations of their own. The response continued beyond the immediate emergency. Through Coordinated Care's Free Dental and Vision Screening event at The Zone, its team helped assemble produce bags while families accessed dental and vision screenings, prescription glasses, fluoride treatments, and back-to-school resources. Each partnership met a different need. But together, they created something larger: a network of care. The fires reminded Excelsior Wellness that community resilience is not built by one organization or one response. It is built through relationships and the willingness to open a door, share a resource, bring a meal, provide care, or simply stand beside someone when they need support. For many of its neighbors, recovery will take much longer than the emergency itself. Excelsior Wellness recognize the profound loss experienced by those who lost their homes, belongings, stability, and sense of safety. Excelsior Wellness is grateful to everyone who helped Excelsior Wellness continue serving its community during a difficult time. These partnerships showed Excelsior Wellness what is possible when Excelsior Wellness move toward one another. When Excelsior Wellness show up for each other, Excelsior Wellness create more than a response. Excelsior Wellness create community. To explore a partnership with Excelsior Wellness, contact its Advancement Team: [email protected]
Dentsply Sirona and Novavax face significant operational challenges, while Molina Healthcare shows more promise, according to a recent stock analysis. Healthcare stocks have returned 25.1% over the past six months, outperforming the S&P 500 by 13.1 percentage points. Dentsply Sirona, which manufactures dental equipment, has seen earnings per share drop 13.6% annually over five years. Its negative returns on capital suggest management is losing money whilst attempting to expand the business. Novavax, a vaccine developer, has experienced revenue declining 18.9% annually over the last five years. The company's adjusted operating margin fell 26.9 percentage points over two years as it struggled to adjust its cost structure. Both companies face regulatory pressures typical of the healthcare sector, which can significantly influence their earnings potential.