Care Manager & Care Coordination Specialist

Molina Healthcare; Gilman (IL); On-site; USD 34,000 - 68,000; Full time

Job summary

Molina Healthcare is seeking a care coordination professional to support LTSS-focused care management across the care continuum in Illinois. You will work with a multidisciplinary team to ensure quality, cost-effective member care and adherence to care plans.

This role involves frequent field activity to assess needs and coordinate services. The ideal candidate has healthcare experience with LTSS, strong communication skills, and the ability to navigate diverse settings.

Qualifications

• 2+ years health care experience including LTSS and care management.
• Active clinical license/certification if required by state.
• Bachelor's degree in a health care related field may be required in some states.
• Valid driver's license, reliable transportation for travel.
• Knowledge of community resources.
• Ability to work with diverse populations and multitask.
• Strong verbal and written communication skills.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans, including a waiver service plan with members, caregivers, physicians and other health care professionals.
• Monitors care plan effectiveness, documents interventions and outcomes, and updates when needed.
• Promotes integration of services for LTSS and behavioral health with home and community resources.
• Assesses medical necessity and authorizes applicable waiver services.
• Evaluates covered benefits and funding sources as needed.
• Facilitates ICT meetings for approval/denial and collaboration.
• Uses motivational interviewing to educate and support member change.
• Identifies barriers to care and provides coordination to address psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans for member safety.
• Collaborates with licensed care managers as needed.
• 25-40% estimated local travel may be required.

Job description

Molina Healthcare is seeking a care coordination professional to support LTSS-focused care management across the care continuum in Illinois. You will work with a multidisciplinary team to ensure quality, cost-effective member care and adherence to care plans.

This role involves frequent field activity to assess needs and coordinate services. The ideal candidate has healthcare experience with LTSS, strong communication skills, and the ability to navigate diverse settings.