Care Manager, LTSS & Integrated Care Coordination

Molina Healthcare, Inc.; Sandwich (MA); On-site; USD 35,000 - 68,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a Care Coordinator to support LTSS and care management, coordinating services across a multidisciplinary team to achieve desired outcomes for members with high-need potential.

The role involves comprehensive assessments, waiver enrollment, care plan development, monitoring and collaboration with providers, with travel as required by state contracts. Strong communication and problem-solving skills are essential.

Qualifications

• 2+ years healthcare experience including LTSS or care management experience.
• Clinical licensure/certification required only if mandated by state contract; active and unrestricted.
• Bachelor's degree may be required in some states.
• Valid driver's license and reliable transportation for travel.
• Knowledge of community resources.
• Ability to work in diverse settings and with varied populations.
• Strong communication and time-management skills.
• Experience with substance use disorders preferred in some states.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians and/or other health care professionals and member support network.
• Performs ongoing monitoring of care plan to evaluate effectiveness and document interventions.
• Promotes integration of services for members including behavioral health care and 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.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change.
• Assesses for barriers to care and provides care coordination to address psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• Collaborates with licensed care managers/leadership as needed or required.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Skills

Care coordination

LTSS experience

Home visits

Multidisciplinary collaboration

Assessments

Communication skills

Time-management

Travel readiness

Independent work

Education

Bachelor's degree in health care

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. is seeking a Care Coordinator to support LTSS and care management, coordinating services across a multidisciplinary team to achieve desired outcomes for members with high-need potential.

The role involves comprehensive assessments, waiver enrollment, care plan development, monitoring and collaboration with providers, with travel as required by state contracts. Strong communication and problem-solving skills are essential.