LTSS Care Manager & Care Coordination Lead

Molina Healthcare, Inc.; Lebanon (OH); On-site; USD 55,000 - 85,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

Molina Healthcare is seeking a dedicated care management professional to support LTSS coordination and integrated member care across settings. You will collaborate with a multidisciplinary team to ensure progress toward outcomes and cost-effective care aligned with state contract requirements.

Responsibilities include conducting comprehensive assessments, waivers enrollment, care plan development, and proactive monitoring.

Qualifications

• Minimum 2 years health care experience with LTSS or care management.
• Clinical licensure/certification as required by state contract.
• Valid driver's license and reliable transportation for travel.

Responsibilities

• 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 with members, caregivers, physicians and support network.
• Performs ongoing monitoring of care plan to evaluate effectiveness and adjust as needed.
• Promotes integration of services across LTSS and behavioral health to improve continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and advises on funding sources.
• Facilitates ICT meetings for approvals/denials and cross-team collaboration.
• Uses motivational interviewing and Molina clinical guidelines to support change.
• Identifies barriers to care and coordinates care to address psycho/social, financial, and medical obstacles.
• Recognizes critical incidents and develops prevention plans for member health and welfare.
• Collaborates with licensed care managers/leadership as needed.
• 25-40% estimated local travel may be required.

Skills

Care coordination

Multidisciplinary teamwork

Communication skills

Travel readiness

Education

Health care related degree or experience

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a dedicated care management professional to support LTSS coordination and integrated member care across settings. You will collaborate with a multidisciplinary team to ensure progress toward outcomes and cost-effective care aligned with state contract requirements.

Responsibilities include conducting comprehensive assessments, waivers enrollment, care plan development, and proactive monitoring.