Care Manager: LTSS & Integrated Care Lead

Molina Healthcare, Inc.; Jerseyville (NJ); Vor Ort; USD 35.000 - 68.000; Vollzeit

Zusammenfassung

Molina Healthcare, Inc. is seeking a Care Coordination professional to support LTSS activities and collaborate with a multidisciplinary team to deliver integrated member care.

You will help coordinate services, conduct home visits as needed, and contribute to strategies for quality and cost-effective care. Responsibilities include comprehensive assessments, waiver enrollment, care plan development, and ongoing monitoring.

Qualifikationen

• Clinical licensure and/or certification required where mandated by state contract/regulation (if applicable).
• Bachelor's degree in a health care related field may be required per state/contract.
• Demonstrated knowledge of community resources and ability to navigate portals/databases.

Aufgaben

• Complete comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians and the care team.
• Monitor and document care plan effectiveness and progress toward goals.
• Coordinate LTSS with behavioral health and community resources for continuity of care.
• Assess medical necessity and authorize waiver services; evaluate benefits and funding sources.
• Lead or participate in ICT meetings for approval/denial of services and collaboration.
• Utilize motivational interviewing and Molina guidelines to educate and support member changes.
• Identify barriers to care and coordinate support to address psycho/social, financial, and medical challenges.
• Identify critical incidents and develop prevention plans to protect member health.
• Travel 25-40% locally as required by state/contract.

Kenntnisse

Care coordination

Communication skills

Time management

Problem-solving

Ausbildung

Bachelor's degree in health care related field

Clinical licensure/certification (if required)

Tools

Microsoft Office

Jobbeschreibung

Molina Healthcare, Inc. is seeking a Care Coordination professional to support LTSS activities and collaborate with a multidisciplinary team to deliver integrated member care.

You will help coordinate services, conduct home visits as needed, and contribute to strategies for quality and cost-effective care. Responsibilities include comprehensive assessments, waiver enrollment, care plan development, and ongoing monitoring.