Care Coordination Specialist, LTSS & Waiver Services

Molina Healthcare, Inc.; Elgin (IL); On-site; USD 35,000 - 68,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a care coordination professional to support LTSS members. You will work with a multidisciplinary team to assess, plan and monitor member care, aiming for quality outcomes and cost-effective care.

Travel to member homes and various sites may be required as part of care delivery. The role emphasizes comprehensive assessments, waiver processes, and collaborative care planning with physicians, caregivers, and networks.

Qualifications

• 2+ years healthcare experience, including LTSS exposure.
• Licensure/certification required only if state contract mandates it.
• Bachelor's degree in a health care related field may be required by state.
• Valid driver's license, reliable transportation, and auto insurance for travel.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians and support network.
• Monitor care plan effectiveness and document interventions.
• Promote integration of LTSS and behavioral health services for continuity of care.
• Assess medical necessity and authorize waiver services.
• Coordinate ICT meetings for service approval/denial.
• Use motivational interviewing and Molina guides to educate and motivate change.
• Identify barriers to care and coordinate psycho/social, financial, and medical support.
• Develop prevention plans for member health and welfare.
• Collaborate with licensed care managers as needed.
• Travel 25-40% locally as required.

Skills

Verbal communication

Written communication

Time management

Detail oriented

Independent work

Education

Bachelors in healthcare field

Tools

Microsoft Office

Online portals/databases

Job description

Molina Healthcare, Inc. is seeking a care coordination professional to support LTSS members. You will work with a multidisciplinary team to assess, plan and monitor member care, aiming for quality outcomes and cost-effective care.

Travel to member homes and various sites may be required as part of care delivery. The role emphasizes comprehensive assessments, waiver processes, and collaborative care planning with physicians, caregivers, and networks.