Field Care Navigator (LTSS & Waiver)

Molina Healthcare; Batavia (IL); On-site; USD 34,000 - 68,000; Full time

Job summary

Molina Healthcare is hiring a care management professional to support LTSS activities, coordinating member care across settings and contributing to value-based outcomes. You will work with a multidisciplinary team to ensure quality, cost-effective services and timely regulatory-compliant assessments.

Key duties include comprehensive assessments, waiver enrollment, care plan development, monitoring, and facilitating interdisciplinary care team meetings, with travel as required (25-40%).

Qualifications

• At least 2 years of health care experience, including at least 1 year with LTSS and 1 year in care management.
• Clinical licensure/certification required only if state contract mandates; active and unrestricted where applicable.
• Bachelor’s degree in a health care related field may be required in some states.
• Valid driver’s license and auto insurance for job-related travel.
• Demonstrated knowledge of community resources.
• Ability to work in diverse settings and with various populations.
• Independent work style with self-motivation and proactive approach.
• Strong verbal and written communication skills.
• Proficiency with Microsoft Office and online portals.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with member and care network.
• Monitors care plan effectiveness and documents interventions.
• Promotes integration of LTSS with behavioral health and community resources.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and funding sources.
• Facilitates ICT meetings for service decisions.
• Uses motivational interviewing and Molina guideposts in member contacts.
• Assesses barriers to care and assists with psycho/social, financial, and medical obstacles.
• Identifies incidents and develops prevention plans.
• Collaborates with licensed care managers as needed.
• 25-40% travel may be required.

Skills

Care management

LTSS

Healthcare experience

Communication

Time management

Problem solving

Microsoft Office

Education

Bachelor’s degree in health care

Tools

Microsoft Office

Job description

Molina Healthcare is hiring a care management professional to support LTSS activities, coordinating member care across settings and contributing to value-based outcomes. You will work with a multidisciplinary team to ensure quality, cost-effective services and timely regulatory-compliant assessments.

Key duties include comprehensive assessments, waiver enrollment, care plan development, monitoring, and facilitating interdisciplinary care team meetings, with travel as required (25-40%).