LTSS Care Manager & Waiver Services Navigator

Molina Healthcare, Inc.; Tiskilwa (IL); In loco; USD 35.000 - 68.000; Tempo pieno

Vantaggi offerti da questo lavoro

Competitive benefits

Travel up to 40%

Descrizione del lavoro

Molina Healthcare, Inc. in Illinois seeks a Care Manager to support LTSS care coordination and collaborate with a multidisciplinary team to deliver integrated member care across the continuum.

The role emphasizes assessing needs, developing care plans with members and providers, and ensuring progress toward outcomes while navigating regulated timelines and waiver services. Travel up to 40% may be required.

Competenze

• At least 2 years of health care experience, including LTSS and care management.
• Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
• Valid and unrestricted driver’s license, reliable transportation, and adequate auto insurance for job related travel requirements.
• Demonstrated knowledge of community resources.
• Ability to work within a variety of settings and adjust style as needed—working with diverse populations.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work independently, with minimal supervision and self-motivation.
• In some states, must have at least one year of experience working directly with individuals with substance use disorders.

Mansioni

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and LTSS and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• Collaborates with licensed care managers/leadership as needed or required.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Conoscenze

Care management

Interdisciplinary collaboration

Motivational interviewing

Communication skills

Microsoft Office

Formazione

Bachelor's degree in a health care related field

Strumenti

Microsoft Office Suite

Descrizione del lavoro

Molina Healthcare, Inc. in Illinois seeks a Care Manager to support LTSS care coordination and collaborate with a multidisciplinary team to deliver integrated member care across the continuum.

The role emphasizes assessing needs, developing care plans with members and providers, and ensuring progress toward outcomes while navigating regulated timelines and waiver services. Travel up to 40% may be required.