Field-Based LTSS Care Manager & Coordination

Jobtome; Newark (NJ); On-site; USD 33,000 - 65,000; Full time

Job summary

Molina Healthcare seeks a skilled care management professional to support LTSS and care coordination for high-need members. You will collaborate with multidisciplinary teams to ensure quality, cost-effective care and smooth waiver processes.

Responsibilities include home visits, care-plan development, and advocating for appropriate services while managing barriers across systems. Travel may be required.

Qualifications

• 2+ years of health care experience, including LTSS and care management.
• 1 year of experience with persons with disabilities/chronic conditions is preferred.
• Licensure/certification required only if state contract/regulation requires it.

Responsibilities

• Complete comprehensive member assessments within regulatory timelines, including in-person home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians, and supports.
• Monitor care plan effectiveness and adjust as needed.
• Promote service integration across behavioral health and LTSS.
• Assess medical necessity and authorize waiver services.
• Evaluate benefits and advise on funding sources.
• Lead ICT meetings for service approvals/denials and collaboration.
• Use motivational interviewing and Molina guidelines to educate and support change.
• Identify barriers to care and coordinate psychosocial, financial, and medical support.
• Identify critical incidents and develop prevention plans for member welfare.
• Collaborate with licensed care managers as needed.
• Travel 25-40% depending on state/contract requirements.

Skills

Healthcare experience

Care management

Communication skills

Time management

Problem solving

Microsoft Office proficiency

Education

CCM

LVN/LPN license

Bachelor's degree in health care

Tools

Microsoft Office

Job description

Molina Healthcare seeks a skilled care management professional to support LTSS and care coordination for high-need members. You will collaborate with multidisciplinary teams to ensure quality, cost-effective care and smooth waiver processes.

Responsibilities include home visits, care-plan development, and advocating for appropriate services while managing barriers across systems. Travel may be required.