LTSS Care Manager & Care Coordination Specialist

Molina Healthcare, Inc.; Racine (WI); Presencial; USD 33.000 - 64.000; Jornada completa

Descripción de la vacante

Molina Healthcare, Inc. is seeking a care management professional to support LTSS activities and coordinate integrated member care. You will work with a multidisciplinary team to help high-need members progress toward outcomes and align care with organizational strategy for quality and cost-effective services.

The role involves home visits, waiver enrollment/disenrollment, care plan implementation, and ongoing monitoring. Travel up to 25–40% may be required depending on state contracts and needs.

Formación

• 2+ years health care experience with LTSS or related fields preferred.
• Ability to read and interpret medical and social care documentation.
• Proven communication and coordination skills across multidisciplinary teams.
• Valid driver’s license and reliable transportation for local travel.

Responsabilidades

• Complete comprehensive member assessments within timelines, including home visits.
• Coordinate waiver enrollment/disenrollment and develop care plans with stakeholders.
• Monitor care plan effectiveness, document interventions, and adjust as needed.
• Promote integration of LTSS and behavioral health with home/community resources.
• Assess medical necessity and authorize waiver services; evaluate benefits and funding.
• Facilitate ICT meetings for approval/denial of services and collaboration.
• Educate and support members using motivational interviewing per Molina guides.
• Identify barriers to care and assist with psycho/social, financial, and medical issues.
• Develop prevention plans for critical incidents; collaborate with care managers.

Conocimientos

Communication

Time management

Problem solving

Independence

Detail-oriented

Educación

Bachelor's degree in health care related field

Certified Case Manager (CCM)

Herramientas

Microsoft Office

Descripción del empleo

Molina Healthcare, Inc. is seeking a care management professional to support LTSS activities and coordinate integrated member care. You will work with a multidisciplinary team to help high-need members progress toward outcomes and align care with organizational strategy for quality and cost-effective services.

The role involves home visits, waiver enrollment/disenrollment, care plan implementation, and ongoing monitoring. Travel up to 25–40% may be required depending on state contracts and needs.