LTSS Care Manager & Waiver Coordinator

Molina Healthcare, Inc.; Staunton (VA); On-site; USD 35,000 - 68,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a care coordination professional to support LTSS services.

This role collaborates with a multidisciplinary team to coordinate integrated member care, ensuring progress toward outcomes while contributing to quality and cost-effective care. Responsibilities include conducting comprehensive assessments, developing care plans, monitoring effectiveness, and promoting service integration across LTSS and behavioral health.

Qualifications

• 2+ years of health care experience, including 1+ year with persons with disabilities or chronic conditions in LTSS, and 1+ year in care management or related setting.
• Clinical licensure/certification required only if state contract mandates; if licensed, active/unrestricted.
• Some states require a health-care related bachelor's degree.
• Valid driver's license, reliable transportation, and adequate auto insurance for travel.
• Knowledge of community resources.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits when required.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement care plans including a waiver service plan with members, caregivers, physicians, and other professionals.
• Monitor care plan to evaluate effectiveness and document interventions.
• Promote integration of LTSS with behavioral health and community resources.
• Assess medical necessity and authorize waiver services.
• Facilitate ICT meetings for approval/denial of services.
• Educate and motivate members using motivational interviewing and Molina guidelines.
• Identify barriers to care and provide coordination and assistance for psycho/social, financial, and medical obstacles.
• Identify critical incidents and develop prevention plans.
• Collaborate with licensed care managers as needed.
• Travel 25-40% based on state/contract requirements.

Skills

Healthcare experience

LTSS experience

Care management

Driver's license

Communication skills

MS Office proficiency

Education

Bachelor's degree (health care related)

Tools

MS Office

Job description

Molina Healthcare, Inc. is seeking a care coordination professional to support LTSS services.

This role collaborates with a multidisciplinary team to coordinate integrated member care, ensuring progress toward outcomes while contributing to quality and cost-effective care. Responsibilities include conducting comprehensive assessments, developing care plans, monitoring effectiveness, and promoting service integration across LTSS and behavioral health.