LTSS Care Manager: Integrated Care & Outcomes

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

Benefits offered by this job

Competitive benefits package

Job summary

Molina Healthcare is seeking a Care Management Specialist to support LTSS activities, coordinating with a multidisciplinary team to deliver integrated member care. You will focus on achieving desired outcomes and contribute to strategies for high-quality, cost-effective care.

You will complete comprehensive assessments, manage waiver processes, develop and monitor care plans, and coordinate with physicians, caregivers, and care managers. Travel of 25–40% may be required based on state contracts.

Qualifications

• At least 2 years of health care experience, with LTSS experience preferred.
• Clinical licensure and/or certification may be required by state contract or regulation.
• Bachelor’s degree in a health care field may be required in some states.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates waiver enrollment/disenrollment processes.
• Develops and implements care plans with members, caregivers, and professionals.
• Monitors care plan effectiveness and documents interventions.
• Promotes integration of services across behavioral health, LTSS, and community resources.
• Assess for medical necessity and authorize waiver services.
• Collaborates with ICT meetings for service approvals/denials.

Skills

Healthcare experience

Care management

Communication skills

Time management

Independent work

Education

Bachelor’s degree in healthcare

Tools

Microsoft Office

Database navigation

Job description

Molina Healthcare is seeking a Care Management Specialist to support LTSS activities, coordinating with a multidisciplinary team to deliver integrated member care. You will focus on achieving desired outcomes and contribute to strategies for high-quality, cost-effective care.

You will complete comprehensive assessments, manage waiver processes, develop and monitor care plans, and coordinate with physicians, caregivers, and care managers. Travel of 25–40% may be required based on state contracts.