LTSS Care Navigator

Jobtome; South Milwaukee (WI); On-site; USD 33,000 - 64,000; Full time

Benefits offered by this job

Competitive benefits

Equal Opportunity Employer (EOE)

Job summary

Molina Healthcare is seeking a care coordinator to support LTSS activities, performing member assessments, developing care plans, and coordinating waiver services with a multidisciplinary team.

The role involves monitoring care plans, promoting service integration, determining medical necessity, and assisting members with psycho/social and financial barriers. Travel 25-40% may be required.

Qualifications

• Minimum 2 years of health care experience, LTSS preferred.
• 1 year in care management or medical/behavioral health setting.
• Valid driver's license and dependable transportation.

Responsibilities

• 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.
• Performs ongoing monitoring of care plan to evaluate effectiveness and document interventions.
• Promotes integration of services for members including behavioral health care and LTSS.
• Assesses for medical necessity and authorizes waiver services.
• Evaluates covered benefits and advises regarding funding sources.
• Facilitates interdisciplinary care team meetings for approval/denial of services.
• Uses motivational interviewing and Molina clinical guideposts to educate and motivate change.
• Assesses barriers to care and assists with psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans.

Skills

Verbal and written communication

Time-management and prioritization

Independent work capability

Problem-solving skills

Knowledge of community resources

Education

Bachelor's degree in health care or related field

Clinical licensure/certification (if required by state contract)

Tools

Microsoft Office

Online portals/databases

Job description

Molina Healthcare is seeking a care coordinator to support LTSS activities, performing member assessments, developing care plans, and coordinating waiver services with a multidisciplinary team.

The role involves monitoring care plans, promoting service integration, determining medical necessity, and assisting members with psycho/social and financial barriers. Travel 25-40% may be required.