LTSS Care Manager & Care Coordination Lead

Jobtome; Kansas; On-site; USD 35,000 - 68,000; Full time

Job summary

Molina Healthcare in the United States seeks a dedicated care management professional to coordinate long-term services and supports (LTSS) for high-need members. You will collaborate with a multidisciplinary team to ensure quality, cost-effective member care and achieve outcomes across the care continuum.

Key duties include comprehensive assessments, waiver enrollment, care-plan development, and ongoing monitoring. Travel up to 40% may be required depending on state contracts and service area.

Qualifications

• 2+ years health care experience including LTSS and care management

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians and others.
• Monitor care plans and adjust interventions as needed.
• Coordinate services across behavioral health, LTSS, and community resources.
• Assess medical necessity and authorize waiver services.
• Evaluate benefits and funding sources.
• Lead ICT meetings for approvals/denials.
• Use motivational interviewing to educate and motivate change.
• Identify barriers and assist with psycho/social, financial, medical challenges.
• Identify critical incidents and develop prevention plans.
• Collaborate with licensed care managers as needed.
• Travel 25-40% as required.

Skills

Care management

LTSS experience

Communication skills

Licensure required

Travel ability

Microsoft Office

Substance use experience

Education

Bachelor's degree

Clinical license/certification (if required)

Tools

EHR systems

Job description

Molina Healthcare in the United States seeks a dedicated care management professional to coordinate long-term services and supports (LTSS) for high-need members. You will collaborate with a multidisciplinary team to ensure quality, cost-effective member care and achieve outcomes across the care continuum.

Key duties include comprehensive assessments, waiver enrollment, care-plan development, and ongoing monitoring. Travel up to 40% may be required depending on state contracts and service area.