LTSS Care Manager - Integrated Care Coordinator

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

Job summary

Molina Healthcare seeks a care management professional to support LTSS activities, coordinating with a multidisciplinary team to ensure member progress toward outcomes and cost-effective, quality care across the continuum.

The role involves comprehensive assessments, waiver enrollment, care plan development with collaboration from members, caregivers, physicians, and a broader support network, and ongoing monitoring and adjustment of plans to meet member needs.

Qualifications

• At least 2 years of health care experience, including at least 1 year with persons with disabilities/chronic conditions LTSS and 1 year in care management.
• Clinical licensure and/or certification required only if state contract, regulation, or licensing mandates require it; if licensed, license must be active and unrestricted.
• In some states, a bachelor's degree in a health care related field may be required.
• Valid and unrestricted driver's license, reliable transportation, and auto insurance for travel requirements.
• Demonstrated knowledge of community resources.
• Ability to work independently with minimal supervision and self-motivation.
• Strong verbal and written communication skills.
• Proficiency in Microsoft Office and navigating online portals/databases.
• In some states, at least one year of experience working with individuals with substance use disorders.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians, and others to address needs and goals.
• Performs ongoing monitoring of care plan effectiveness and documents interventions and goal achievement.
• Promotes integration of services for LTSS and behavioral health to enhance continuity of care.
• Assess for medical necessity and authorize appropriate waiver services.
• Evaluates covered benefits and advises on funding sources.
• Facilitates interdisciplinary care team meetings for approval/denial of services.
• Uses motivational interviewing and Molina clinical guides to educate and support change.
• Assesses barriers to care and provides coordination for psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans.
• Collaborates with licensed care managers/leadership as needed.
• 25-40% estimated local travel may be required based on state/contractual requirements.

Skills

Health care experience

Care management

Disabilities LTSS knowledge

Strong communication

Time management

Adaptability

Independent work

Relationship building

Problem solving

Travel readiness

Education

Bachelor's degree health care field

Licensure or certification (where required)

Tools

Microsoft Office

Job description

Molina Healthcare seeks a care management professional to support LTSS activities, coordinating with a multidisciplinary team to ensure member progress toward outcomes and cost-effective, quality care across the continuum.

The role involves comprehensive assessments, waiver enrollment, care plan development with collaboration from members, caregivers, physicians, and a broader support network, and ongoing monitoring and adjustment of plans to meet member needs.