LTSS Care Manager: Integrated Care & Waiver Coordination

Molina Healthcare; Medora (IL); On-site; USD 34,000 - 68,000; Full time

Job summary

Molina Healthcare is seeking a Care Manager to support LTSS-focused activities and coordinate member care across multidisciplinary teams in Medora, IL. The role emphasizes comprehensive assessments, waiver services, and development of person-centered care plans with caregivers and providers.

Responsibilities include monitoring progress, coordinating services with behavioral health and community resources, and ensuring timely authorization of needed services.

Qualifications

• At least 2 years health care experience with LTSS, and 1 year in care management or equivalent.
• Clinical licensure/certification required only if state contract mandates it, active and unrestricted if licensed.
• Bachelor's degree may be required in certain states/contractual requirements.
• Valid driver’s license, reliable transportation, and adequate auto insurance for travel.
• Strong knowledge of community resources and ability to work across settings.

Responsibilities

• Complete comprehensive member assessments within timelines, including home visits as required.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians and networks.
• Monitor care plan effectiveness, document interventions and adjust as needed.
• 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 and collaboration.
• Use motivational interviewing and Molina clinical guideposts in member contacts.
• Identify barriers to care and coordinate solutions for psycho/social and medical obstacles.
• Travel 25-40% locally as required by state/contractual requirements.

Skills

Healthcare experience

Care management

Communication skills

Time management

MS Office

Education

Bachelor's degree in health care related field

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Care Manager to support LTSS-focused activities and coordinate member care across multidisciplinary teams in Medora, IL. The role emphasizes comprehensive assessments, waiver services, and development of person-centered care plans with caregivers and providers.

Responsibilities include monitoring progress, coordinating services with behavioral health and community resources, and ensuring timely authorization of needed services.