LTSS Care Manager: Integrated Care & Waiver Services

Jobtome; Stewardson (IL); On-site; USD 35,000 - 68,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare in Illinois seeks a Care Manager to support LTSS member care coordination and manage comprehensive assessments and care plans. You will collaborate with a multidisciplinary team to ensure quality and cost-effective member care across the continuum.

Responsibilities include waiver enrollment/disenrollment, monitoring plan effectiveness, and engaging with caregivers, physicians, and community resources. Travel to member sites is expected up to 40% as required by state contracts.

Qualifications

• At least 2 years of health care experience, including LTSS exposure.
• Clinical licensure or certification required only if state contract mandates.
• Bachelor's degree in a health care related field may be required depending on state.
• Valid and unrestricted driver’s license, reliable transportation, and adequate auto insurance for job travel.
• Demonstrated knowledge of community resources.
• Ability to work with diverse populations and varying settings.
• Strong communication, time-management, and problem-solving skills.
• Proficiency with Microsoft Office and online portals.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians and other health care professionals and support network.
• Monitors care plan effectiveness, documents interventions and goal achievement, and suggests changes.
• Promotes integration of LTSS with behavioral health care and community resources to enhance continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates covered benefits and funding sources.
• Facilitates interdisciplinary care team meetings for approval/denial of services.
• Uses motivational interviewing and Molina clinical guideposts to educate and motivate change.
• Assesses 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.
• Travel 25-40% may be required.

Job description

Molina Healthcare in Illinois seeks a Care Manager to support LTSS member care coordination and manage comprehensive assessments and care plans. You will collaborate with a multidisciplinary team to ensure quality and cost-effective member care across the continuum.

Responsibilities include waiver enrollment/disenrollment, monitoring plan effectiveness, and engaging with caregivers, physicians, and community resources. Travel to member sites is expected up to 40% as required by state contracts.