LTSS Care Manager: Integrated Care & Outcomes

Molina Healthcare; Peoria (IL); On-site; USD 65,000 - 90,000; Full time

Job summary

Molina Healthcare is seeking a Care Manager to support LTSS care coordination and member outcomes across the continuum. The role collaborates with a multidisciplinary team to ensure quality and cost-effective care for members with high-need potential.

Responsibilities include conducting comprehensive member assessments, coordinating waiver services, developing care plans, and supporting members, caregivers, and providers through the care journey.

Qualifications

• At least 2 years of health care experience, including LTSS exposure.
• Clinical licensure/certification required only if mandated by state contracts.
• Bachelor's degree may be required in some states.
• Valid driver's license, reliable transportation for travel.
• Knowledge of community resources.
• Ability to work in diverse settings and manage multiple projects.
• Strong communication and organizational skills.
• Experience with substance use disorders in some states.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians, and care team.
• Monitor care plans, document interventions and outcomes, adjust as needed.
• Promote integration of LTSS, behavioral health, and community resources.
• Assess medical necessity and authorize waiver services.
• Lead ICT meetings for service approvals/denials and collaboration.
• Identify barriers to care and support members to address psycho/social/financial obstacles.
• Travel 25-40% as required by state contracts.

Skills

Health care experience

Care management

Communication skills

Time management

Problem-solving

Microsoft Office

Education

Bachelor's degree in health care field

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Care Manager to support LTSS care coordination and member outcomes across the continuum. The role collaborates with a multidisciplinary team to ensure quality and cost-effective care for members with high-need potential.

Responsibilities include conducting comprehensive member assessments, coordinating waiver services, developing care plans, and supporting members, caregivers, and providers through the care journey.