Field Care Navigator for LTSS & Care Coordination

Molina Talent Acquisition; Illinois; On-site; USD 60,000 - 90,000; Full time

Job summary

Molina Healthcare is seeking a care management professional to support LTSS activities and coordinate member care across settings. You will collaborate with a multidisciplinary team to advance member outcomes while contributing to cost-effective care delivery.

In this role you will conduct assessments, enroll/disenroll in waiver programs, develop and monitor care plans, and navigate benefits and funding options. Travel up to 40% may be required based on state contracts.

Qualifications

• At least 2 years of healthcare experience with LTSS and disability/common chronic conditions.
• Clinical licensure/certification only if required by state contract; active/unrestricted if licensed.
• Bachelor's degree may be required in some states/contractual scenarios.
• Valid driver's license and reliable transportation for travel.
• Knowledge of community resources and how to connect members to services.
• Ability to work in diverse settings with various populations.
• Ability to work independently with minimal supervision.
• Strong verbal and written communication skills.
• Proficiency with Microsoft Office and online portals/databases.
• Experience with substance use disorders in some states is a plus.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans with a waiver service plan in collaboration with members, caregivers, physicians, and others.
• Monitors care plans, documents interventions, and suggests changes as needed.
• Promotes integration of behavioral health, LTSS, and home/community resources for continuity of care.
• Assesses medical necessity and authorizes waiver services where appropriate.
• Evaluates covered benefits and advises on funding sources.
• Facilitates ICT meetings for approval or denial of services.
• Uses motivational interviewing and Molina clinical guideposts to educate and motivate change.
• Assesses barriers to care and provides coordination to address psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans for member welfare.
• Collaborates with licensed care managers/leadership as required.
• Travel 25–40% may be required depending on state/contractual requirements.

Skills

Verbal and written communication

Time-management

Prioritization

Problem-solving

Independence / self-motivation

Working with diverse populations

Attention to detail

Interpersonal relationships

Proactive work style

Knowledge of community resources

Education

Bachelor's degree in healthcare

Tools

MS Office

Online portals / databases

Job description

Molina Healthcare is seeking a care management professional to support LTSS activities and coordinate member care across settings. You will collaborate with a multidisciplinary team to advance member outcomes while contributing to cost-effective care delivery.

In this role you will conduct assessments, enroll/disenroll in waiver programs, develop and monitor care plans, and navigate benefits and funding options. Travel up to 40% may be required based on state contracts.