LTSS Care Manager — Integrated Care & Outcomes

Molina Healthcare, Inc.; Racine (WI); On-site; USD 52,000 - 78,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

Molina Healthcare seeks a care coordination professional to support LTSS-focused services, coordinate member care across settings, and collaborate with multidisciplinary teams. The role emphasizes comprehensive assessments, waiver processes, and individualized care plans to improve outcomes while managing costs.

The candidate will work with diverse populations, utilize motivational interviewing, and navigate portals and databases.

Qualifications

• At least 2 years of health care experience including LTSS and care management.
• Clinical licensure/certification required only if mandated by state contract/regulation.
• Bachelor's degree may be required in some states.
• Valid and unrestricted driver’s license and reliable transportation.
• Knowledge of community resources and ability to navigate portals/databases.
• Ability to work independently with minimal supervision.
• Strong verbal and written communication skills.
• MS Office proficiency and ability to use online portals.

Responsibilities

• Complete comprehensive member assessments within regulated timelines; include in-person home visits as required.
• Facilitate waiver enrollment/disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians, and care networks.
• Monitor care plan effectiveness and document interventions and goal achievement.
• Promote integration of LTSS and behavioral health services and community resources.
• Assess medical necessity and authorize appropriate waiver services.
• Facilitate ICT meetings for approval/denial of services.
• Travel 25–40% locally as required.

Skills

Care coordination

LTSS experience

Care management

Home visits

Communication skills

Time management

Driver's license

Microsoft Office

Education

Healthcare-related bachelor's degree

Tools

Electronic Health Records (EHR)

Job description

Molina Healthcare seeks a care coordination professional to support LTSS-focused services, coordinate member care across settings, and collaborate with multidisciplinary teams. The role emphasizes comprehensive assessments, waiver processes, and individualized care plans to improve outcomes while managing costs.

The candidate will work with diverse populations, utilize motivational interviewing, and navigate portals and databases.