LTSS Care Manager - Integrated Care & Waiver Services

Molina Healthcare, Inc.; Peoria (AZ); Vor Ort; USD 35.000 - 68.000; Vollzeit

Zusammenfassung

Molina Healthcare, Inc. is seeking a care coordination specialist to support LTSS-focused activities and collaborate with a multidisciplinary team to deliver integrated member care across settings.

You will drive comprehensive assessments, develop and monitor care plans, and facilitate waiver processes while ensuring high-quality, cost-effective outcomes. Travel up to 40% may be required depending on state contracts.

Qualifikationen

• 2+ years in health care including LTSS/care management
• Clinical licensure/certification if required by state contract
• Bachelor's degree in health care or related field may be required
• Valid driver's license and transportation for travel
• Proficiency with Microsoft Office and online portals

Aufgaben

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, and providers.
• Monitors care plan effectiveness and documents interventions and outcomes.
• Promotes service integration for LTSS and behavioral health to improve continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and advises on funding sources.
• Facilitates ICT meetings for service approvals/denials.
• Uses motivational interviewing and Molina clinical guidelines to support change.
• Addresses barriers to care and coordinates psycho/social, financial, and medical support.
• Identifies critical incidents and develops prevention plans.
• Collaborates with licensed care managers as needed.
• 25-40% local travel may be required.

Kenntnisse

Care coordination

LTSS experience

Care management

Strong communication

Travel ready

MS Office

Ausbildung

Bachelor's degree in health care

Tools

Microsoft Office

Jobbeschreibung

Molina Healthcare, Inc. is seeking a care coordination specialist to support LTSS-focused activities and collaborate with a multidisciplinary team to deliver integrated member care across settings.

You will drive comprehensive assessments, develop and monitor care plans, and facilitate waiver processes while ensuring high-quality, cost-effective outcomes. Travel up to 40% may be required depending on state contracts.