LTSS Care Manager & Waiver Coordinator

Molina Healthcare, Inc.; Danville (IL); On-site; USD 65,000 - 90,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a care management professional to coordinate LTSS services and collaborate with a multidisciplinary team to ensure high-need members receive integrated care across the continuum.

The role involves comprehensive assessments, care planning with caregivers and clinicians, and ongoing monitoring to achieve desired outcomes while navigating regulatory timelines and waiver processes. Local travel will be required.

Qualifications

• Requires care management or LTSS experience.
• Experience with disabilities or chronic conditions LTSS.
• Strong communication and coordination skills.
• Must possess a valid driver’s license for travel.
• Proficiency in Microsoft Office and online portals.

Responsibilities

• Complete comprehensive member assessments within timelines, including in-person visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians, and support network.
• Monitor care plan effectiveness and document progress towards goals.
• Promote integration of services across LTSS, behavioral health, and community resources.
• Assess medical necessity and authorize waiver services.
• Evaluate benefits and advise on funding sources.
• Lead ICT meetings for service approvals or denials.
• Use motivational interviewing to educate and support member changes.
• Identify barriers and coordinate care to address psycho/social, financial, and medical obstacles.
• Identify critical incidents and develop prevention plans to protect member health.
• Collaborate with licensed care managers as needed.
• Travel 25-40% may be required.

Skills

Care management

LTSS

Disabilities

Driver's license

Communication

Team collaboration

Job description

Molina Healthcare, Inc. is seeking a care management professional to coordinate LTSS services and collaborate with a multidisciplinary team to ensure high-need members receive integrated care across the continuum.

The role involves comprehensive assessments, care planning with caregivers and clinicians, and ongoing monitoring to achieve desired outcomes while navigating regulatory timelines and waiver processes. Local travel will be required.