LTSS Care Coordinator & Waiver Specialist

Molina Healthcare, Inc.; Walnut (IL); Sur place; USD 35 000 - 68 000; Plein temps

Avantages offerts par ce poste

Competitive benefits package

EOE M/F/D/V

Résumé du poste

Molina Healthcare, Inc. is seeking a care management professional to support LTSS-related activities and coordinate integrated member care across settings.

You will work with a multidisciplinary team to ensure progress toward outcomes and contribute to strategies for quality and cost-effective care. You will complete comprehensive assessments, develop care plans with stakeholders, monitor progress, and promote service integration, including behavior health and community resources.

Qualifications

• At least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions LTSS, and 1 year of experience in care management, 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.

Responsabilités

• 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 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 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.
• Assesses 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).

Description du poste

Molina Healthcare, Inc. is seeking a care management professional to support LTSS-related activities and coordinate integrated member care across settings.

You will work with a multidisciplinary team to ensure progress toward outcomes and contribute to strategies for quality and cost-effective care. You will complete comprehensive assessments, develop care plans with stakeholders, monitor progress, and promote service integration, including behavior health and community resources.