Care Management Specialist: LTSS & Waiver Services

Molina Healthcare; Seattle (WA); On-site; USD 33,000 - 63,000; Full time

Job summary

Molina Healthcare is seeking a Family Care Specialist to support care management for the My Choice Wisconsin program. You will coordinate LTSS, collaborate with a multidisciplinary team, and help members progress toward outcomes while ensuring cost-effective care.

The role involves comprehensive assessments, waiver processes, care plan development, and ongoing monitoring. Travel locally 25-40% may be required based on state contracts.

Qualifications

• 2+ years health care experience with LTSS or care management experience.
• Clinical licensure/certification as required by state contract/licensing mandates.
• Bachelor’s degree may be required in some states.

Responsibilities

• Complete comprehensive member assessments within timelines, including home visits as needed.
• Facilitate waiver enrollment/disenrollment processes.
• Develop and implement care plans with member, caregivers and professionals.
• Monitor care plans, document outcomes, and adjust as needed.
• Promote service integration across behavioral health and LTSS.
• Assess medical necessity and authorize waiver services.
• Evaluate benefits and funding sources.
• Lead ICT meetings for service approvals/denials.
• Educate and motivate members using motivational interviewing.
• Identify barriers to care and coordinate psycho/social support.
• Collaborate with licensed care managers and leadership as required.
• Travel locally 25-40% as required by state/contract.

Skills

Health care experience

Care management

Disabilities/chronic conditions LTSS

Communication skills

Time management

Self-motivation

Problem-solving

Proactive work style

Substance use disorders exp

License required (if state contract)

Education

Bachelor's degree in health care field

Tools

Microsoft Office

Online portals/databases

Job description

Molina Healthcare is seeking a Family Care Specialist to support care management for the My Choice Wisconsin program. You will coordinate LTSS, collaborate with a multidisciplinary team, and help members progress toward outcomes while ensuring cost-effective care.

The role involves comprehensive assessments, waiver processes, care plan development, and ongoing monitoring. Travel locally 25-40% may be required based on state contracts.