Care Manager - LTSS & Care Coordination

Molina Healthcare; Milwaukee (WI); On-site; USD 39,000 - 65,000; Full time

Job summary

Molina Healthcare in Milwaukee, WI is seeking a care coordination professional to support LTSS and care management for members with high-need potential. You will collaborate with a multidisciplinary team to develop and monitor waiver plans, visit members, and ensure integrated, quality care across services.

Responsibilities include comprehensive assessments, Waiver enrollment processes, care plan development, and ongoing monitoring.

Qualifications

• At least 2 years of health care experience, including 1 year with disabilities/LTSS.
• Clinical licensure and/or certification required only if mandated by state contract.
• Possession of a bachelor's degree in a health care related field may be required by state contract.
• Valid driver's license, reliable transportation, and auto insurance for travel.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans in collaboration with members and care network.
• Monitors care plans to evaluate effectiveness and adjust as needed.
• Promotes integration of services including behavioral health and LTSS.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and funding sources and advises accordingly.
• Facilitates ICT meetings for approval/denial of services.
• Uses motivational interviewing to educate and motivate change.
• Identifies barriers to care and provides coordination to address obstacles.
• Collaborates with licensed care managers as needed.
• 25-40% local travel may be required.

Skills

Healthcare experience

LTSS experience

Care management

Driver's license

Communication skills

Microsoft Office

Education

Bachelor's degree in health care

Tools

Microsoft Office

Job description

Molina Healthcare in Milwaukee, WI is seeking a care coordination professional to support LTSS and care management for members with high-need potential. You will collaborate with a multidisciplinary team to develop and monitor waiver plans, visit members, and ensure integrated, quality care across services.

Responsibilities include comprehensive assessments, Waiver enrollment processes, care plan development, and ongoing monitoring.