LTSS Care Manager: Care Coordination & Outcomes

Molina Healthcare; Illinois; In loco; USD 34.000 - 68.000; Tempo pieno

Descrizione del lavoro

Molina Healthcare in the United States is seeking a Care Manager to support LTSS care coordination. You will collaborate with a multidisciplinary team to ensure coordinated member care, complete timely assessments, and develop/implement care plans with members and providers.

The role emphasizes assessing medical necessity, advocating for appropriate waiver services, promoting service integration, and guiding members through barriers.

Competenze

• At least 2 years healthcare experience, incl. 1 year with LTSS and 1 year care management or related setting.
• Licensure and/or certification required only if state contract mandates; active/unrestricted license.
• Bachelor's degree may be required in some states depending on state/contractual requirements.
• Valid driver's license and reliable transportation for travel.
• Knowledge of community resources.
• Ability to work in diverse settings with varied populations.
• Proactive, detail-oriented, and capable of working independently.
• Strong written and verbal communication skills.
• Proficient with Microsoft Office and navigating online portals.
• Some states require experience with individuals with substance use disorders.

Mansioni

• 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 members, caregivers, physicians and others.
• Monitors and documents care plan progress and adjusts as needed.
• Promotes integration of LTSS with behavioral health and home resources.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and funding sources.
• Facilitates ICT meetings for service approval/denial.
• Uses motivational interviewing to educate and motivate change.
• Assesses barriers and coordinates psycho/social, financial, and medical support.
• Identifies critical incidents and develops prevention plans.
• Collaborates with licensed care managers as needed.
• Travel 25-40% may be required.

Conoscenze

Care management

Communication skills

Time management

Problem solving

Travel willingness

Independent work

Formazione

Bachelor's degree (health care)

Clinical licensure

Strumenti

Microsoft Office

Descrizione del lavoro

Molina Healthcare in the United States is seeking a Care Manager to support LTSS care coordination. You will collaborate with a multidisciplinary team to ensure coordinated member care, complete timely assessments, and develop/implement care plans with members and providers.

The role emphasizes assessing medical necessity, advocating for appropriate waiver services, promoting service integration, and guiding members through barriers.