LTSS Care Manager: Care Coordination & Outcomes

Molina Healthcare, Inc.; Johnstown (Cambria County); On-site; USD 33,000 - 64,000; Full time

Job summary

Molina Healthcare is seeking a care management professional to support LTSS-focused activities and coordinate member care across the continuum. You will work with a multidisciplinary team to ensure progress toward outcomes and align care with strategic goals for quality and cost-effectiveness.

The role involves comprehensive assessments, waiver processes, care plan development, and ongoing monitoring. Travel up to 40% may be required, with strong emphasis on community resources and

Qualifications

• 2+ years of health care experience including LTSS/care management.
• Driver's license and reliable transportation.
• Active license if required by state contract/regulation.
• Bachelor's degree may be required in some states.
• Proficient with Microsoft Office and online portals.
• Experience with individuals with substance use disorders in some states.
• Ability to work independently with minimal supervision.
• Strong problem-solving, verbal and written communication skills.

Responsibilities

• Completes member assessments within regulated timelines, including home visits.
• Facilitates waiver enrollment/disenrollment processes.
• Develops and implements care plans with members and care team.
• Monitors care plans and documents interventions and outcomes.
• Promotes integration of services to enhance continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and advises on funding sources.
• Supports ICT meetings for service approvals/denials.
• Uses motivational interviewing to educate and motivate change.
• Addresses psycho/social and financial barriers to care.
• Identifies incidents and develops prevention plans.
• Collaborates with licensed care managers as needed.
• Travel 25-40% may be required.

Skills

Care management

LTSS

Communication

Office software

Independent work

Problem solving

Travel readiness

Education

CCM Certification

LVN/LPN license

Bachelor's degree (healthcare related)

Tools

Microsoft Office

Online portals & databases

Job description

Molina Healthcare is seeking a care management professional to support LTSS-focused activities and coordinate member care across the continuum. You will work with a multidisciplinary team to ensure progress toward outcomes and align care with strategic goals for quality and cost-effectiveness.

The role involves comprehensive assessments, waiver processes, care plan development, and ongoing monitoring. Travel up to 40% may be required, with strong emphasis on community resources and