LTSS Care Manager: Coordination & Waiver Services

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

Job summary

Molina Healthcare, Inc. is seeking a care management professional to support LTSS-specific activities and coordinate integrated member care across settings.

You will work with a multidisciplinary team to ensure progress toward outcomes and contribute to strategies that improve quality and cost-effectiveness. You will develop and monitor individualized care plans, conduct in-person assessments, and facilitate waiver processes.

Qualifications

• 2+ years health care experience with LTSS or disability/chronic conditions
• Clinical licensure/certification required only if state contract requires it
• Bachelor's degree may be required in some states
• Valid driver's license and reliable transportation required
• Experience with community resources and diverse populations
• Strong communication and ability to work independently and with minimal supervision
• Proficiency in MS Office and online portals/databases

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits
• Facilitate waiver enrollment/disenrollment processes
• Develop and implement care plans with members, caregivers, physicians and the care team
• Monitor and document care plan effectiveness and adjust as needed
• Promote integration of LTSS with behavioral health and community resources
• Assess medical necessity and authorize waiver services
• Collaborate with interdisciplinary care teams for service approvals/denials
• Conduct ICT meetings and educate using Molina clinical guideposts
• Identify barriers to care and coordinate solutions for psycho/social, financial, medical needs
• Travel 25-40% as required by state/contractual requirements

Skills

Care management

LTSS experience

Communication skills

Driver's license

Time management

Collaboration

Problem-solving

Education

Bachelor's degree in health care

Tools

MS Office

Job description

Molina Healthcare, Inc. is seeking a care management professional to support LTSS-specific activities and coordinate integrated member care across settings.

You will work with a multidisciplinary team to ensure progress toward outcomes and contribute to strategies that improve quality and cost-effectiveness. You will develop and monitor individualized care plans, conduct in-person assessments, and facilitate waiver processes.