LTSS Care Manager: Integrated Care and Home Visits

Molina Healthcare, Inc.; Edwardsville (IL); On-site; USD 35,000 - 68,000; Full time

Job summary

Molina Healthcare, Inc. seeks a care management professional to support LTSS care coordination. You will work with a multidisciplinary team to coordinate integrated member care, ensure timely assessments, and implement effective care plans.

Responsibilities include waiver management, documentation, and collaboration with providers, caregivers, and family members. Travel may be required to meet state contracts and member needs.

Qualifications

• 2+ years healthcare experience with LTSS or similar setting.
• 1+ year in care management or medical/behavioral health setting.
• Active/undisclosed licensure if state contract requires.
• Bachelor's degree may be required per state/contract.
• Valid driver's license and transportation for travel.
• Knowledge of community resources.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members and care team.
• Monitor and adjust care plans to achieve goals.
• Promote integrated services across LTSS and behavioral health.
• Assess medical necessity and authorize waiver services.
• Advise on benefits and funding sources.
• Lead ICT meetings for service approvals/denials.
• Use motivational interviewing and Molina guidelines.
• Identify barriers and coordinate supportive care.
• Identify incidents and plan prevention measures.
• Collaborate with licensed care managers as needed.
• Travel 25–40% as required by state/contractual rules.

Skills

Verbal communication

Written communication

Time management

Prioritization

Problem solving

Independence

Community resources knowledge

Diversity awareness

Microsoft Office proficiency

Education

Bachelor's degree in health care field

Clinical licensure/certification (if required)

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. seeks a care management professional to support LTSS care coordination. You will work with a multidisciplinary team to coordinate integrated member care, ensure timely assessments, and implement effective care plans.

Responsibilities include waiver management, documentation, and collaboration with providers, caregivers, and family members. Travel may be required to meet state contracts and member needs.