Care Manager, Ltss- Must Reside In Id

Molina Healthcare; Caldwell (ID); On-site; USD 61,892,812 - 134,130,024; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare is seeking a qualified care coordination professional in Idaho to support members with high-need potential across the continuum of care. The role emphasizes coordinating integrated services, managing care plans, and promoting quality outcomes.

The position involves collaborating with multidisciplinary teams, ensuring timely assessments, travel as needed, and adherence to regulatory requirements while maintaining a person-centered approach to member care.

Qualifications

• Requires residence in Idaho and healthcare experience including LTSS knowledge.
• Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) license where required by state contract.
• Proficiency with Microsoft Office and health care software portals.
• Ability to travel 25–40% locally as dictated by state requirements.

Responsibilities

• Complete comprehensive member assessments within timelines, including home visits as needed.
• Coordinate waiver enrollment/disenrollment processes.
• Develop and implement care plans with members, caregivers and providers.
• Monitor care plan effectiveness and adjust as needed to achieve goals.
• Promote integrated services across behavioral health and LTSS.
• Assess medical necessity and authorize waiver services.

Skills

Communication skills

Time management

Problem solving

Team collaboration

Self-motivation

Independent work

Education

LPN/LVN license

Healthcare degree (BS/BA)

Tools

Microsoft Office

Online portals & databases

Job description

JOB DESCRIPTION Job Summary

Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long-term services and supports (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 and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assess for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• 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).

Required Qualifications

• MUST RESIDE IN IDAHO state.
• At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
• Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Demonstrated knowledge of community resources.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work independently, with minimal supervision and self-motivation.
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving, and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).

Preferred Qualifications

• Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice.
• Experience working with populations that receive waiver services.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $21.6 - $46.81 / HOURLY

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.