LTSS Care Manager & Care Coordination Specialist

Molina Healthcare; Sycamore (IL); On-site; USD 34,000 - 68,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare is seeking a dedicated care coordination professional to support LTSS and care management for high-need members. You will work with a multidisciplinary team to develop and monitor person-centered care plans, ensuring timely assessments and waiver services across settings.

Responsibilities include engaging with members, caregivers, and providers, coordinating care across behavioral health and LTSS, and traveling to required sites.

Qualifications

• At least 2 years of health care experience, including at least 1 year with persons with disabilities/chronic conditions LTSS, and 1 year in care management or related setting.
• Clinical licensure and/or certification required only if mandated by state contract or licensing mandates.
• In some states, a bachelor's degree in a health care related field may be required.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job-related travel.
• Demonstrated knowledge of community resources.
• Ability to work independently with minimal supervision and self-motivation.
• Strong time-management and prioritization skills; ability to handle multiple projects.
• Strong verbal and written communication skills.
• Microsoft Office suite proficiency and ability to navigate online portals/databases.
• In some states, at least one year of experience working directly with individuals with substance use disorders.

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 the member and care network.
• Monitors care plan effectiveness and documents interventions and goal achievement.
• Promotes integration of services to enhance continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates covered benefits and advises on funding sources.
• Facilitates interdisciplinary care team meetings for service decisions.
• Uses motivational interviewing to educate and motivate change.
• Assesses barriers to care and provides coordination to address obstacles.
• Identifies critical incidents and develops prevention plans.
• Collaborates with licensed care managers when needed.
• 25-40% estimated local travel may be required.

Skills

Healthcare experience

Care management

Verbal and written communication

Time-management

Problem-solving

Education

Bachelor's degree in health care

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a dedicated care coordination professional to support LTSS and care management for high-need members. You will work with a multidisciplinary team to develop and monitor person-centered care plans, ensuring timely assessments and waiver services across settings.

Responsibilities include engaging with members, caregivers, and providers, coordinating care across behavioral health and LTSS, and traveling to required sites.