Care Manager

Molina Healthcare; Illinois; On-site; USD 60,000 - 82,000; Full time

Job summary

Molina Healthcare is seeking a skilled Care Manager to coordinate member care across the continuum and collaborate with a multidisciplinary team. The role focuses on driving quality and cost-effective outcomes through proactive assessment, planning and care coordination.

Responsibilities include developing care plans with members and providers, conducting visits, monitoring progress and promoting integrated services to improve continuity of care. Local travel will be required.

Qualifications

• At least 2 years experience in health care, care management, or related field.
• Clinical licensure/certification required only if mandated by state contract.
• Valid driver’s license and reliable transportation for travel.

Responsibilities

• Completes assessments within regulated timelines and identifies care coordination eligibility.
• Develops care plans with member, caregiver, physician and team to meet goals.
• Performs telephonic, in-person or home visits as needed.
• Monitors care plan effectiveness and documents interventions and outcomes.
• Maintains ongoing member caseload with regular outreach and support.
• Promotes service integration across behavioral health, LTSS and community resources.
• Facilitates ICT meetings and cross-disciplinary collaboration.
• Uses motivational interviewing to educate and motivate change.
• Assesses barriers to care and provides coordination assistance as needed.
• Travels 25-40% locally as required by state contracts.

Skills

Care coordination

Communication skills

Time management

Travel flexibility

Education

Bachelor’s degree in health care

Tools

MS Office

Electronic Health Records

Job description

JOB DESCRIPTION Job Summary

Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• Completes assessments of members per regulated timelines and determines who may qualify for care coordination/care management based on triggers identified in assessments.
• Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• Collaborates with licensed care managers/leadership as needed or required.
• 25- 40% estimated local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
• Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Demonstrated knowledge of community resources.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations
• Ability to work independently, with minimal supervision and self-motivation.
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).

Molina Healthcare offers a competitive benefits and compensation package.

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V