Care Navigator (LTSS & Care Coordination)

Molina Healthcare; Chicago Heights (IL); On-site; USD 3,472,000 - 6,771,000; Full time

Job summary

Molina Healthcare seeks a Care Coordinator to support LTSS and care management activities. You will collaborate with a multidisciplinary team to coordinate member care across the continuum and help drive outcomes and cost-effective services.

You will assess needs, develop care plans including waiver services, and monitor progress while liaising with caregivers, physicians, and the member network. Travel up to 40% may be required in certain states.

Qualifications

• At least 2 years of health care experience, including LTSS exposure.
• Clinical licensure/certification required only if state contract mandates.
• Bachelor's degree in a health care field may be required in some states.

Responsibilities

• 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 with members, caregivers, physicians and other health care professionals.
• Monitors care plans to evaluate effectiveness and document interventions.
• Promotes integration of services including behavioral health and LTSS and community resources.
• Assesses medical necessity and authorizes waiver services.
• Facilitates ICT meetings for approval/denial of services.
• Uses motivational interviewing to educate and motivate change.
• Assesses barriers to care and assists members with psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans.
• Collaborates with licensed care managers as needed.
• 25-40% local travel may be required.

Skills

Care coordination

Healthcare experience

Disability support

Communication skills

Time management

Independent worker

Travel willing

Education

Bachelor's degree in healthcare

Tools

Microsoft Office

Online portals/databases

Job description

Molina Healthcare seeks a Care Coordinator to support LTSS and care management activities. You will collaborate with a multidisciplinary team to coordinate member care across the continuum and help drive outcomes and cost-effective services.

You will assess needs, develop care plans including waiver services, and monitor progress while liaising with caregivers, physicians, and the member network. Travel up to 40% may be required in certain states.