LTSS Care Manager & Care Coordination Specialist

Molina Healthcare, Inc.; La Salle (CO); On-site; USD 35,000 - 68,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a care management professional to support LTSS-specific activities and coordinate member care across the continuum.

You will work with a multidisciplinary team to ensure progress toward outcomes and contribute to strategies that deliver quality, cost-effective care. You will complete regulated assessments, develop care plans, monitor progress, and collaborate with caregivers and physicians while navigating community resources and supporting members in diverse

Qualifications

• Healthcare experience required with LTSS or care management background.
• Clinical licensure and/or certification only if mandated by state contract/regulation.
• Valid driver's license, reliable transportation for travel requirements.

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 other health professionals.
• Performs ongoing monitoring of care plans to evaluate effectiveness and adjust interventions and goals.
• Promotes integration of services for LTSS and behavioral health to enhance continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates covered benefits and advises on funding sources.
• Facilitates ICT meetings for approval or denial of services.
• Uses motivational interviewing and Molina clinical guideposts to educate and motivate change.
• Identifies barriers to care and coordinates psycho/social, financial, and medical support.
• Identifies critical incidents and develops prevention plans.
• Collaborates with licensed care managers/leadership as needed.
• 25-40% estimated local travel may be required.

Skills

Care management

Communication skills

Time management

Problem solving

Independent work

Interdisciplinary collaboration

Resource navigation

Verbal communication

Education

Bachelor's degree in healthcare/related field

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. is seeking a care management professional to support LTSS-specific activities and coordinate member care across the continuum.

You will work with a multidisciplinary team to ensure progress toward outcomes and contribute to strategies that deliver quality, cost-effective care. You will complete regulated assessments, develop care plans, monitor progress, and collaborate with caregivers and physicians while navigating community resources and supporting members in diverse