Care Manager, LTSS & Waiver Services

Molina Healthcare Inc; Milwaukee (WI); On-site; USD 60,000 - 75,000; Full time

Job summary

Molina Healthcare Inc is seeking a Care Manager for LTSS-focused care coordination. This role collaborates with a multidisciplinary team to coordinate member care across the continuum, ensuring progress toward outcomes and alignment with cost-effective strategies.

Responsibilities include completing assessments, developing care plans with stakeholders, monitoring plan effectiveness, and facilitating waiver processes. Travel 25-40% may be required depending on state contracts.

Qualifications

• 2+ years of health care experience, including LTSS/care management.
• Clinical licensure/certification required only if state contract mandates.
• Bachelor's degree in a health care field may be required per state.
• Valid driver's license, reliable transportation, and travel readiness.
• Knowledge of community resources and ability to navigate systems.
• Ability to work independently with minimal supervision.
• Experience with individuals with substance use disorders preferred in some states.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including home visits.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers and providers.
• Monitor care plan effectiveness and document interventions and outcomes.
• Promote integration of behavioral health and LTSS services for continuity of care.
• Assess medical necessity and authorize appropriate waiver services.
• Facilitate interdisciplinary care team meetings for approvals/denials.
• Educate and motivate members using motivational interviewing and clinical guides.
• Identify barriers to care and coordinate support networks; travel as required.

Skills

Time management

Communication skills

Independent work

Problem solving

Travel flexibility

Microsoft Office

Cultural sensitivity

Education

Health care bachelor's degree

Tools

Microsoft Office

Job description

Molina Healthcare Inc is seeking a Care Manager for LTSS-focused care coordination. This role collaborates with a multidisciplinary team to coordinate member care across the continuum, ensuring progress toward outcomes and alignment with cost-effective strategies.

Responsibilities include completing assessments, developing care plans with stakeholders, monitoring plan effectiveness, and facilitating waiver processes. Travel 25-40% may be required depending on state contracts.