Care Manager

Molina Healthcare; Peoria (IL); On-site; USD 52,000 - 68,000; Full time

Benefits offered by this job

Benefits package

Job summary

Molina Healthcare, Inc. is seeking a care management professional to support care coordination activities and collaborate with a multidisciplinary team to deliver integrated member care across settings.

The role includes assessments, care planning with members and providers, home visits, ongoing monitoring, and promoting linkage to behavioral health, LTSS, and community resources. Travel may be required up to 25-40% depending on state requirements.

Qualifications

• 2 years or more in health care, preferably care management or related setting.
• Clinical licensure/certification required only if state contract mandates.
• Valid driver’s license and auto insurance for travel requirements.
• Knowledge of community resources.
• Ability to work independently with minimal supervision.
• Strong verbal and written communication skills.

Responsibilities

• Complete member assessments within regulated timelines and determine care coordination eligibility.
• Develop and implement care plans with members and providers.
• Conduct telephonic, home visits or in-person visits as required.
• Monitor care plans and document interventions and outcomes.
• Maintain ongoing member caseload and outreach.
• Promote integration of services across behavioral health, LTSS, and community resources.
• Facilitate ICT meetings and collaboration.
• Address barriers to care and coordinate with leadership as needed.
• Travel may be required up to 25-40% depending on state requirements.

Skills

Communication skills

Time management

Detail-oriented

Self-motivation

Independent work

Education

Bachelor’s degree in health care field

Tools

Microsoft Office

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