LTSS Care Manager: Coordinated Care & Outcomes

Molina Healthcare; Miami (FL); On-site; USD 33,000 - 63,000; Full time

Job summary

Molina Healthcare in Miami, FL is seeking a Care Manager to support LTSS care coordination across the continuum. The role partners with a multidisciplinary team to coordinate member care, develop and monitor care plans, and ensure progress toward outcomes.

You will assess needs, facilitate waiver processes, collaborate with physicians and the care team, and help navigate benefits and resources. Travel 25-40% may be required based on state contracts.

Qualifications

• At least 2 years of health care experience, including LTSS experience.
• Clinical licensure and/or certification required where mandated by state contract/regulation.
• In some states, a bachelor's degree in a health care related field may be required.
• Valid driver's license and reliable transportation for travel.
• Experience with community resources and diverse populations.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians and others.
• Monitors care plan effectiveness and updates as needed.
• Promotes integration of services across LTSS and behavioral health care.
• Assess for medical necessity and authorize waiver services.
• Evaluate benefits and advise on funding sources.
• Facilitate ICT meetings for approval/denial of services.
• Educate and motivate change using motivational interviewing and Molina guides.
• Identify barriers to care and coordinate solutions for psycho/social, financial, and medical issues.
• Identify critical incidents and develop prevention plans.
• Collaborate with licensed care managers and leadership.
• Travel 25-40% may be required.

Skills

Care coordination

Communication skills

Problem-solving

Time management

Independent work

Education

Bachelor's degree in health care related field

Tools

Microsoft Office

Job description

Molina Healthcare in Miami, FL is seeking a Care Manager to support LTSS care coordination across the continuum. The role partners with a multidisciplinary team to coordinate member care, develop and monitor care plans, and ensure progress toward outcomes.

You will assess needs, facilitate waiver processes, collaborate with physicians and the care team, and help navigate benefits and resources. Travel 25-40% may be required based on state contracts.