LTSS Care Manager: Waiver & Care Coordination

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

Job summary

Molina Healthcare, Inc. is seeking a care management professional to support LTSS activities and coordinate member care across diverse settings. Role involves collaborating with a multidisciplinary team to ensure high-need members progress toward outcomes and cost-effective care.

The position emphasizes waiver enrollment, care plan development, and ongoing monitoring, with 25-40% travel. Strong communication, independence, and knowledge of community resources are essential.

Qualifications

• At least 2 years of health care experience, including 1 year with persons with disabilities/ LTSS.
• License must be active and unrestricted if required by state contract.
• In some states, a bachelor’s degree in a health care related field may be required.
• Valid and unrestricted driver’s license, reliable transportation, and adequate auto insurance for job related travel.
• Demonstrated knowledge of community resources.
• Ability to work independently, with minimal supervision and self-motivation.
• Strong verbal and written communication skills.
• In some states, at least one year of experience with individuals with substance use disorders.

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 and care network.
• Monitors care plan effectiveness and documents progress toward goals.
• Promotes integration of LTSS and behavioral health services for continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and funding sources for members.
• Facilitates ICT meetings for service approval/denial.
• Educates and motivates members using motivational interviewing and clinical guidelines.
• Identifies barriers to care and coordinates support to address psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans.
• Coordinates with licensed care managers and leadership as needed.
• 25-40% estimated local travel may be required.

Skills

Care management

Care coordination

Communication skills

Microsoft Office

Travel readiness

Education

Bachelor's degree in health care or related field

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. is seeking a care management professional to support LTSS activities and coordinate member care across diverse settings. Role involves collaborating with a multidisciplinary team to ensure high-need members progress toward outcomes and cost-effective care.

The position emphasizes waiver enrollment, care plan development, and ongoing monitoring, with 25-40% travel. Strong communication, independence, and knowledge of community resources are essential.