LTSS Care Manager: Coordinated, Outcome-Driven Care

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

Benefits offered by this job

Competitive benefits

Equal opportunity employer

Job summary

Molina Healthcare in Illinois seeks a care management professional to support LTSS coordination for high-need members, including home visits when required. You will collaborate with a multidisciplinary team to coordinate integrated care across the continuum and drive outcomes that improve quality and cost-effectiveness.

You will develop and monitor care plans, assess medical necessity, and guide members to community resources.

Qualifications

• At least 2 years health care experience with LTSS/care management.
• Clinical licensure and/or certification required only if mandated by state contract.
• Bachelor's degree may be required in some states.
• Valid and unrestricted driver's license for job-related travel.
• Demonstrated knowledge of community resources.
• Ability to work independently with minimal supervision.
• Strong communication and time-management skills.
• Proficiency in Microsoft Office and online portals.
• Experience with individuals with substance use disorders in some states.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including home visits when required.
• Facilitates waiver enrollment/disenrollment processes.
• Develops and implements care plans including waiver service plans with stakeholders.
• Monitors care plans and documents interventions and outcomes.
• Promotes LTSS integration and connects members to community resources.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and advises on funding sources.
• Facilitates ICT meetings for service approvals/denials and collaboration.
• Uses motivational interviewing and Molina guides to support change.
• Identifies barriers to care and assists with psycho/social/financial obstacles.
• Identifies incidents and develops prevention plans; ensures member welfare.
• Collaborates with licensed care managers as needed.
• 25-40% local travel may be required.

Job description

Molina Healthcare in Illinois seeks a care management professional to support LTSS coordination for high-need members, including home visits when required. You will collaborate with a multidisciplinary team to coordinate integrated care across the continuum and drive outcomes that improve quality and cost-effectiveness.

You will develop and monitor care plans, assess medical necessity, and guide members to community resources.