Care Manager — LTSS & Waiver Care Coordination

Molina Healthcare; Kenosha (WI); On-site; USD 33,062 - 64,485; Full time

Job summary

Molina Healthcare is seeking a care management professional to support LTSS activities for Family Care with My Choice Wisconsin. The role collaborates with a multidisciplinary team to coordinate integrated member care across the continuum and drive outcomes.

Responsibilities include comprehensive assessments, waiver processes, care plan development, ongoing monitoring, and promoting service integration to optimize quality and cost-effective care.

Qualifications

• Minimum 2 years of health care experience, including LTSS exposure.
• Clinical licensure/certification required if mandated by state contract/regulation.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates waiver enrollment/disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians and support network.
• Monitors care plan effectiveness and documents interventions and goal achievement.
• Promotes integration of services and access to home and community resources to improve continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Implements ICT coordination for service approvals/denials.
• Educates and motivates change during member contacts using motivational interviewing.
• Identifies barriers to care and coordinates psycho/social, financial, and medical support.
• Provides travel as required (25-40%).

Skills

Care coordination

Communication skills

Documentation

MS Office

Time management

Travel readiness

Interdisciplinary collaboration

Education

Bachelor's degree in health care or related field

Tools

EHR systems

Job description

Molina Healthcare is seeking a care management professional to support LTSS activities for Family Care with My Choice Wisconsin. The role collaborates with a multidisciplinary team to coordinate integrated member care across the continuum and drive outcomes.

Responsibilities include comprehensive assessments, waiver processes, care plan development, ongoing monitoring, and promoting service integration to optimize quality and cost-effective care.