LTSS Care Manager: Care Coordination & Waiver Services

Molina Healthcare, Inc.; Cincinnati (AR); On-site; USD 60,000 - 80,000; Full time

Job summary

Molina Healthcare, Inc. is hiring a Care Management Specialist to support LTSS activities and coordinate member care across the continuum. You will work with a multidisciplinary team to ensure quality, cost-effective care and progress toward optimal member outcomes.

The role involves comprehensive assessments, waiver processes, care plan development, ongoing monitoring, and coordination across care settings. Local travel of 25–40% is required to meet state contract obligations.

Qualifications

• At least 2 years of health care experience with LTSS, and care management experience.
• Licensure/certification required only if state contract mandates it.
• Bachelor's degree may be required in some states.

Responsibilities

• Complete comprehensive member assessments within timelines, including in-person visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members and care team.
• Monitor care plan effectiveness and document outcomes.
• Promote service integration across behavioral health and LTSS.
• Assess medical necessity and authorize waiver services.
• Coordinate ICT meetings for care approvals/denials.
• Educate and motivate members using motivational interviewing.
• Identify barriers and coordinate psychosocial, financial, and medical support.
• Travel 25–40% as required by state contracts.

Skills

Healthcare experience

Communication

MS Office

Time management

Independent work

Detail oriented

Education

Bachelor's degree (healthcare related)

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. is hiring a Care Management Specialist to support LTSS activities and coordinate member care across the continuum. You will work with a multidisciplinary team to ensure quality, cost-effective care and progress toward optimal member outcomes.

The role involves comprehensive assessments, waiver processes, care plan development, ongoing monitoring, and coordination across care settings. Local travel of 25–40% is required to meet state contract obligations.