Care Manager: LTSS & Care Coordination Expert

Jobtome; Town of Grafton (WI); On-site; USD 35,000 - 68,000; Full time

Benefits offered by this job

Competitive benefits

Travel for local visits

Job summary

Molina Healthcare in the United States seeks a care coordination professional to support care management and LTSS activities, collaborating with a multidisciplinary team to ensure high-quality, cost-effective member care and outcomes.

Responsibilities include member assessments, waiver enrollment/disenrollment, care plan development, and ongoing monitoring; travel to member sites may be 25-40% to support service integration and continuity of care.

Qualifications

• 2+ years healthcare experience with LTSS or care management preferred.
• Clinical licensure/certification required only if state contract/regulation demands.
• Valid driver's license and reliable transportation for travel.

Responsibilities

• Completes comprehensive member assessments within regulated timelines and may require home visits.
• Facilitates waiver enrollment/disenrollment processes.
• Develops and implements care plans with members, caregivers and professionals.
• Monitors care plan effectiveness and documents interventions and goal achievement.
• Promotes integration of LTSS and behavioral health services for continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and funding sources and collaborates with ICT meetings.
• Uses motivational interviewing and Molina clinical guidelines to support change.
• Assesses barriers and coordinates support for psycho/social, financial, and medical needs.
• Identifies critical incidents and develops prevention plans; travel 25-40% may be required.

Skills

Healthcare experience

Care management

Communication skills

Microsoft Office

Driving required

Substance use disorders experience

Education

Bachelor’s degree in health care field

CCM certification preferred

LVN/LPN license preferred

Tools

Microsoft Office

Job description

Molina Healthcare in the United States seeks a care coordination professional to support care management and LTSS activities, collaborating with a multidisciplinary team to ensure high-quality, cost-effective member care and outcomes.

Responsibilities include member assessments, waiver enrollment/disenrollment, care plan development, and ongoing monitoring; travel to member sites may be 25-40% to support service integration and continuity of care.