Care Manager, LTSS & Care Coordination

Molina Healthcare; Elgin (IL); On-site; USD 35,000 - 68,000; Full time

Benefits offered by this job

Competitive benefits and compensation

Job summary

Molina Healthcare is hiring in Elgin, IL for a care management professional who coordinates LTSS and care services for high-need members. You will collaborate with multidisciplinary teams to ensure integrated delivery of care and adherence to regulatory timelines, including home visits as required.

Required are 2+ years in health care with LTSS or care management experience; a license is necessary if mandated by state contracts.

Qualifications

• Minimum 2 years health care experience, including LTSS or care management exposure.
• Clinical licensure/certification as required by state contract or regulation.
• Bachelor’s degree in health care may be required in some states.

Responsibilities

• Complete comprehensive member assessments within regulated timelines and during-home visits when required.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians, and care team.
• Monitor and evaluate care plans, document interventions, and adjust as needed.
• Coordinate services across behavioral health and LTSS to ensure continuity of care.
• Assess medical necessity and authorize waiver services; evaluate benefits and funding sources.
• Lead ICT meetings for service approvals/denials and collaborate with care teams.
• Educate and motivate members using motivational interviewing and Molina guidelines.
• Identify barriers to care and provide resources for psycho-social, financial, and medical issues.
• Identify critical incidents and create prevention plans; maintain professional relationships.
• Travel 25-40% locally as required by state/contractual requirements.

Skills

Care coordination

Disability experience

Communication

Microsoft Office

Time management

Problem-solving

Tools

Microsoft Office Suite

Job description

Molina Healthcare is hiring in Elgin, IL for a care management professional who coordinates LTSS and care services for high-need members. You will collaborate with multidisciplinary teams to ensure integrated delivery of care and adherence to regulatory timelines, including home visits as required.

Required are 2+ years in health care with LTSS or care management experience; a license is necessary if mandated by state contracts.