LTSS Care Manager: Care Coordination & Support

Molina Healthcare, Inc.; Hilliard (OH); On-site; USD 33,000 - 64,000; Full time

Benefits offered by this job

Benefits package

Equal Opportunity Employer

Job summary

Molina Healthcare, Inc. is seeking a care management professional to support LTSS delivery and care coordination across the continuum. You will work with a multidisciplinary team to align member care with outcomes, while ensuring quality and cost efficiency.

You will assess, plan, and monitor waiver services, collaborating with members, caregivers, and health professionals to overcome barriers and improve health outcomes.

Qualifications

• :Two years healthcare experience; LTSS experience preferred; care management or related background.
• :Experience with disability/chronic conditions and care management; required by state contracts.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other health care professionals.
• Monitors care plans, documents interventions and adjusts as needed.
• Promotes integration of services across LTSS and behavioral health to ensure continuity of care.
• Assesses medical necessity and authorizes waiver services; evaluates benefits and funding sources.
• Facilitates interdisciplinary care team meetings for approvals/denials; collaborates with ICT.
• Engages members using motivational interviewing and Molina clinical guideposts.
• Identifies barriers to care and provides coordination to address psycho/social, financial, and medical needs.
• Identifies critical incidents and develops prevention plans.
• Collaborates with licensed care managers and leadership as needed.
• Travel up to 25-40% depending on state/contractual requirements.

Skills

Care coordination

Communication

Time management

Problem solving

Education

Bachelor's degree in health care field

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. is seeking a care management professional to support LTSS delivery and care coordination across the continuum. You will work with a multidisciplinary team to align member care with outcomes, while ensuring quality and cost efficiency.

You will assess, plan, and monitor waiver services, collaborating with members, caregivers, and health professionals to overcome barriers and improve health outcomes.