LTSS Care Manager & Care Coordination Specialist

Molina Healthcare; Illinois; Vor Ort; USD 35.000 - 68.000; Vollzeit

Benefits dieser Stelle

Competitive benefits

Equal Opportunity Employer

Zusammenfassung

Molina Healthcare in Illinois seeks a Care Management / LTSS Coordinator to coordinate member care across the continuum for high-need individuals. You will collaborate with a multidisciplinary team to complete assessments, develop and monitor care plans, and ensure timely waiver services.

The role requires strong communication, problem-solving, and the ability to work independently in diverse settings. Travel up to 40% may be required based on state contracts and needs.

Qualifikationen

• At least 2 years of health care experience including LTSS and care management.
• Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).

Aufgaben

• 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/denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assess for barriers to care and provide care coordination to address psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• Collaborates with licensed care managers/leadership as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Kenntnisse

Care coordination

Effective communication

Time management

Problem-solving

Independent work

Ausbildung

Bachelor's degree in health care related field

Tools

Microsoft Office

Online portals

Jobbeschreibung

Molina Healthcare in Illinois seeks a Care Management / LTSS Coordinator to coordinate member care across the continuum for high-need individuals. You will collaborate with a multidisciplinary team to complete assessments, develop and monitor care plans, and ensure timely waiver services.

The role requires strong communication, problem-solving, and the ability to work independently in diverse settings. Travel up to 40% may be required based on state contracts and needs.