Care Manager: LTSS & Care Coordination

Molina Healthcare; Beloit (WI); On-site; USD 33,000 - 63,000; Full time

Job summary

Molina Healthcare is seeking a care coordination professional to support LTSS-related activities and collaborate with an interdisciplinary team to coordinate member care across the continuum.

The role involves comprehensive assessments, waiver enrollment, and development of individualized care plans in partnership with members, caregivers and clinicians. Travel up to 40% may be required based on state contracts and service area.

Qualifications

• Minimum 2 years health care experience, including LTSS, and 1 year in care management or equivalent.
• Clinical licensure and/or certification required only if mandated by state contract or regulations, active if licensed.
• Bachelor's degree may be required in some states per contract requirements.
• Valid and unrestricted driver's license, reliable transportation for travel requirements.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians and care team.
• Monitor care plan effectiveness and update as needed.
• Promote integration of LTSS and behavioral health services.
• Assess medical necessity and authorize waiver services.
• Coordinate ICT meetings for approvals/denials and collaboration.
• Educate and motivate members using motivational interviewing and clinical guides.
• Identify barriers to care and provide resources for psycho/social, financial, and medical needs.
• Travel 25-40% as required by state contracts.

Skills

Care coordination

Multidisciplinary collaboration

Communication

Travel willingness

Job description

Molina Healthcare is seeking a care coordination professional to support LTSS-related activities and collaborate with an interdisciplinary team to coordinate member care across the continuum.

The role involves comprehensive assessments, waiver enrollment, and development of individualized care plans in partnership with members, caregivers and clinicians. Travel up to 40% may be required based on state contracts and service area.