Care Manager, Ltss (Bh Licensed) - Cook County

Jobtome; Chicago (IL); Remote; USD 38,000 - 74,000; Full time

Job summary

Molina Healthcare is seeking a field-based Healthcare Care Coordinator in the greater Cook County area. This role supports care management and LTSS activities, collaborating with a multidisciplinary team to coordinate integrated member care across the continuum.

You will ensure progress toward outcomes, promote service integration including behavioral health, and monitor care plans with regular documentation. Travel is required to support local members and contracts.

Qualifications

• At least 2 years of health care experience including 1 year in care management or medical/behavioral health settings.
• Active state license as listed above (LCSW/LMSW/APSW/LPC/LPCC/LMFT, etc.).
• Valid driver's license and reliable transportation for job travel.
• Ability to work independently with minimal supervision.
• Experience with individuals with disabilities, chronic conditions, LTSS, or substance use disorders.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement care plans in collaboration with members, caregivers, physicians and the care network.
• Monitor care plans to evaluate effectiveness and document progress.
• Promote integration of LTSS and behavioral health services for continuity of care.
• Assess medical necessity and authorize waiver services.
• Facilitate ICT meetings for service approvals.
• Use motivational interviewing to educate and motivate change.
• Identify barriers to care and provide coordination to address psycho/social, financial, and medical obstacles.
• Travel 25-40% locally as required.

Skills

Interdisciplinary collaboration

Motivational interviewing

Strong communication

Time management

Travel readiness

Education

Licensed Social Worker (LCSW/LMSW/APSW/LPC/LPCC/LMFT)

Bachelor's degree in health-related field

Tools

Microsoft Office

Job description

This is a remote field-based role requiring travel in the greater Cook County area.

Job Summary

Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. 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 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 in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services 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 and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• May provide consultation, resources and recommendations to peers as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 2 years of experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
• Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT, Doctor of Psychology (PhD or PsyD) or equivalency based on state contract, regulation, or state board licensing mandate. License must be active and unrestricted in state of practice.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Ability to operate proactively and demonstrate detail-oriented work.
• Demonstrated knowledge of community resources.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations and various personalities and personal situations.
• Ability to work independently, with minimal supervision and demonstrate self-motivation.
• Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Problem-solving skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
• In some states, must have at least one year of experience working directly with individuals with substance use disorders.

Preferred Qualifications

• Certified Case Manager (CCM).
• Experience working with populations that receive waiver services.

#PJHS3#LI-AC1#HTF

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/VPay Range: $27.73 - $54.06 / HOURLY*Actual compensation may vary based on geographic location, work experience, education and/or skill level.