Field Care Manager, LTSS - Eastern Cook County -Local Travel Required

Molina Healthcare; Chicago (IL); On-site; USD 35,000 - 68,000; Full time

Benefits offered by this job

Mileage reimbursement

Job summary

Molina Healthcare is seeking an experienced Care Manager to coordinate LTSS for Medicaid members in Eastern Cook County. The role involves in-home visits, waiver support, and collaboration with a multidisciplinary team to achieve quality, cost-effective care. Strong Microsoft Office skills and travel to local sites are required.

Candidates should have 2+ years in health care and LTSS, plus a relevant degree. Valid driver’s license and the ability to work Mon-Fri 8-5 CST are expected.

Qualifications

• 2+ years in health care, LTSS and care management or equivalent
• Active license if required by state contract
• Bachelor's degree may be required in some states
• Valid driver’s license and reliable transportation
• Experience with community resources and diverse populations
• Strong communication and time management skills
• Experience with substance use disorders is a plus

Responsibilities

• Complete comprehensive member assessments, including in-home visits as required
• Coordinate waiver enrollment/disenrollment processes
• Develop and implement care plans with members and care team
• Monitor care plan effectiveness and adjust as needed
• Promote integration of behavioral health and LTSS services
• Assess medical necessity and authorize waiver services
• Collaborate with care teams and ICT for approvals
• Educate and motivate members using motivational interviewing

Skills

Care management

LTSS experience

Disabilities/Chronic conditions

Medical/behavioral health

Driver's license

Microsoft Office

Communication skills

Team collaboration

Cultural sensitivity

Documentation

Education

Bachelor's degree in health care

Master's degree in social services

Tools

Microsoft Office Suite

Job description

JOB DESCRIPTION

Opportunity for an experienced Care Manager (Bachelors or Masters trained in a social service field) in Eastern Cook County to join our LTSS Team working with our Medicaid members in communities that are between Wicker Park north to West Montrose Avenue. Part of the responsibilities of the role is to conduct face-to-face meetings with the members in their homes. Preference will be given to those candidates with previous care management experience in an MCO. Mileage is reimbursed as part of our benefits package.Hours are Monday – Friday, 8 AM – 5 PM CST.

Solid experience with Microsoft Office Suite is necessary, especially with Outlook, Excel, and Teams as well as being confident in moving between different programs to complete the necessary forms and documentation.

Job Summary

Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• 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, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assess for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• Collaborates with licensed care managers/leadership as needed or required.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
• Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Demonstrated knowledge of community resources.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work independently, with minimal supervision and self-motivation.
• Ability to demonstrate responsiveness in all forms of communication and remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Problem-solving skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
• In some states, must have at least one year of experience working directly with individuals with substance use disorders.

Preferred Qualifications

• Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice.
• Experience working with populations that receive waiver services.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $25.2 - $49.15 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.