LTSS Care Manager: Integrated Care & Waiver Services

Molina Healthcare, Inc.; Columbia (SC); Sur place; USD 35 000 - 68 000; Plein temps

Résumé du poste

Molina Healthcare, Inc. is seeking a care coordination professional to support LTSS-focused activities. You will collaborate with a multidisciplinary team to ensure high-need members receive integrated care across the continuum and progress toward outcomes.

Responsibilities include completing assessments, developing care plans, and advocating for appropriate waiver services. Local travel up to 40% may be required across assigned states.

Qualifications

• 2+ years health care experience, LTSS exposure, and care management experience.
• Clinical licensure/certification as required by state contract or regulation.
• Bachelor's degree may be required in some states.

Responsabilités

• Complete comprehensive member assessments within timelines, including in-person home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, and health professionals.
• Monitor care plans to evaluate effectiveness and adjust as needed.
• Promote integration of LTSS, behavioral health, and community resources.
• Assess medical necessity and authorize waiver services as appropriate.
• Evaluate benefits and advise on funding sources.
• Coordinate ICT meetings for approvals/denials.
• Educate and motivate members using motivational interviewing.
• Identify barriers to care and provide support for psycho/social/financial issues.

Connaissances

Care coordination

LTSS knowledge

Home visits

Interdisciplinary teamwork

Time management

Communication

Regulatory compliance

Driver's license

Travel readiness

Formation

Bachelor's degree in health care

Outils

Microsoft Office

Description du poste

Molina Healthcare, Inc. is seeking a care coordination professional to support LTSS-focused activities. You will collaborate with a multidisciplinary team to ensure high-need members receive integrated care across the continuum and progress toward outcomes.

Responsibilities include completing assessments, developing care plans, and advocating for appropriate waiver services. Local travel up to 40% may be required across assigned states.