LTSS Care Manager - Integrated Care & Waivers

Molina Healthcare, Inc.; Ravenna (OH); On-site; USD 33,000 - 64,000; Full time

Job summary

Molina Healthcare, Inc. seeks a care management professional to coordinate long-term services and supports (LTSS) for members across multiple Ohio counties. You will collaborate with a multidisciplinary team to deliver integrated care and help members progress toward desired outcomes.

The role includes assessing needs, developing care plans with members and providers, and facilitating waiver processes. Travel to local sites (25-40%) may be required, with a focus on high-quality, cost-effective

Qualifications

• 2+ years of health care experience, including LTSS experience and care management experience or equivalent

Responsibilities

• 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, physicians, and network to address needs and goals.
• Monitors care plan effectiveness and documents interventions and goal achievement.
• Promotes integration of services across behavioral health and LTSS with home and community resources.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and funding sources.
• Facilitates ICT meetings for approval/denial of services.
• Uses motivational interviewing and Molina clinical guideposts to support change.
• Identifies barriers to care and coordinates psycho/social, financial, and medical support.
• Identifies critical incidents and develops prevention plans for member health and welfare.
• Collaborates with licensed care managers as needed.
• 25-40% estimated local travel may be required.

Job description

Molina Healthcare, Inc. seeks a care management professional to coordinate long-term services and supports (LTSS) for members across multiple Ohio counties. You will collaborate with a multidisciplinary team to deliver integrated care and help members progress toward desired outcomes.

The role includes assessing needs, developing care plans with members and providers, and facilitating waiver processes. Travel to local sites (25-40%) may be required, with a focus on high-quality, cost-effective