Case Manager, LTSS

Home Health Focus; California (MO); Remote; USD 45,000 - 75,000; Full time

Job summary

An innovative firm is seeking a Licensed Behavioral Health Professional to support Medicaid members through home visits and assessments. This role involves collaborating with healthcare teams to develop and implement effective care plans, ensuring continuity of care for high-need populations. The ideal candidate will thrive in a fast-paced environment, possess strong assessment and communication skills, and be dedicated to enhancing member outcomes. Join a dynamic team that prioritizes quality, cost-effective care while making a meaningful impact in the community.

Benefits

Competitive Benefits

Flexible Schedule

Remote Work Options

Qualifications

• Minimum 1 year working with persons with disabilities or chronic conditions.
• Completion of an accredited LVN or LPN program or relevant degree.

Responsibilities

• Conduct face-to-face assessments and develop care plans.
• Travel 50-75% locally for member visits.
• Facilitate interdisciplinary care team meetings.

Skills

Assessment Skills

Case Management

Communication Skills

Motivational Interviewing

Attention to Detail

Education

Bachelor's degree in Social Sciences

Completion of accredited LVN or LPN program

Tools

High-speed Internet

Job description

JOB DESCRIPTION

We are seeking a Licensed Behavioral Health Professional residing in Illinois, with an active license for the state of Illinois.

The Case Manager will work remotely and in the field, supporting our Medicaid population. The role involves visiting members' homes for face-to-face assessments, participating in interdisciplinary care team meetings, and developing care plans based on members' health concerns and needs. Members require assessments every six months and additional 'trigger assessments' following hospitalizations. Strong computer skills and attention to detail are essential to manage multiple systems, communicate with members, and accurately document contacts. This is a fast-paced position where productivity is critical.

Travel (50% or more) in the surrounding areas will be required for member visits. The primary work location is in the Peoria area, with a home office setup and high-speed internet connectivity necessary.

Schedule: Monday to Friday, 8:00 AM to 5:00 PM. No weekends or holidays.

Job Summary

Molina Healthcare Services (HCS) collaborates with members, providers, and multidisciplinary teams to assess, plan, and coordinate integrated care across behavioral health and long-term services, especially for high-need members. HCS staff aim to ensure that members achieve desired health outcomes through quality, appropriate, and cost-effective care.

Knowledge/Skills/Abilities

• Complete face-to-face comprehensive assessments within regulated timelines.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement case management and waiver service plans in collaboration with members, caregivers, healthcare professionals, and support networks.
• Monitor and evaluate care plan effectiveness, document interventions, and suggest modifications.
• Promote service integration, including behavioral health and long-term supports, to enhance continuity of care.
• Assess medical necessity and authorize waiver services.
• Evaluate benefits and advise on funding sources.
• Conduct required face-to-face or home visits.
• Facilitate interdisciplinary care team meetings for service approvals or denials.
• Use motivational interviewing and clinical guidelines to support and motivate members.
• Identify barriers to care and assist members in addressing psycho/social, financial, and medical concerns.
• Develop prevention plans for critical incidents to ensure member safety.
• Travel 50-75% locally for member visits.

Job Qualifications

Required Education:

• Completion of an accredited LVN or LPN program, or a bachelor's/master’s degree in social sciences, psychology, gerontology, public health, social work, or equivalent education and experience.

Required Experience:

• Minimum 1 year working with persons with disabilities or chronic conditions and long-term services/supports.
• 1-3 years in case management, disease management, managed care, or behavioral health settings.

Preferred Experience:

• 3-5 years in relevant health management roles.
• Experience working with populations receiving waiver services.

Preferred Licenses/Certifications:

• Active and unrestricted CCM certification.
• Active, unrestricted state nursing (LVN/LPN) or clinical social worker license.
• Valid driver’s license with a good record and reliable transportation.

State-Specific Requirements

For Wisconsin: Bachelor's degree or higher in human services with at least one year working with Family Care populations; or a degree in any field with three years of relevant experience.

Current Molina employees should apply via the intranet.

Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer (EOE) M/F/D/V.