Field Care Manager — LTSS Care Coordination

Molina Healthcare; Edwardsville (IL); On-site; USD 39,000 - 74,000; Full time

Job summary

Molina Healthcare is seeking a care management professional to coordinate LTSS and waiver-based services for high-need members. You will collaborate with a multidisciplinary team to ensure integrated delivery of care and progress toward outcomes.

The role involves developing and monitoring individualized care plans, supporting member goals, and addressing barriers to care, including psycho/social and financial factors. Travel up to 25-40% may be required in line with state contracts.

Qualifications

• Minimum 2 years of healthcare experience, including at least 1 year in care management, managed care, or LTSS.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members and care network to address needs and goals.
• Monitors care plans, documents interventions, and adjusts as needed.
• Promotes integration of LTSS with behavioral health and community resources to improve continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and funding sources.
• Coordinates interdisciplinary care team meetings for approvals or denials.
• Uses motivational interviewing and Molina guidelines to educate and motivate change.
• Identifies barriers to care and provides coordination to address psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans for member health and welfare.
• May provide consultation and guidance to peers.
• Travel up to 25-40% may be required.

Skills

Care coordination

Communication

Time management

Problem-solving

Attention to detail

Self-motivation

Education

LCSW

LMSW

APSW

CHES

LPC

LPCC

LMFT

PhD or PsyD

Health care-related bachelor's degree

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a care management professional to coordinate LTSS and waiver-based services for high-need members. You will collaborate with a multidisciplinary team to ensure integrated delivery of care and progress toward outcomes.

The role involves developing and monitoring individualized care plans, supporting member goals, and addressing barriers to care, including psycho/social and financial factors. Travel up to 25-40% may be required in line with state contracts.