LTSS Care Navigator & Care Coordination Specialist

Molina Healthcare; Spring Valley (IL); On-site; USD 35,000 - 68,000; Full time

Benefits offered by this job

Competitive benefits package

Equal Opportunity Employer

Job summary

Molina Healthcare is seeking a care coordination professional in Illinois to support LTSS-focused activities and collaborate with a multidisciplinary team to deliver high-quality, cost-effective member care.

Responsibilities include member assessments, care plan development, service integration, and travel as needed. The role emphasizes motivational interviewing and compliance with state contracts and regulations.

Qualifications

• 2+ years healthcare experience including LTSS.
• 1 year experience in care management or relevant clinical setting.
• Licensure/certification required only if mandated by state contract/regulation.
• Bachelor's degree may be required in some states.
• Valid driver's license and reliable transportation for travel.
• Knowledge of community resources.
• Ability to work across diverse settings and under pressure.
• Strong communication skills, both written and verbal.
• Proficiency with Microsoft Office and online portals.
• Experience with individuals with substance use disorders preferred in some states.

Responsibilities

• Complete comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members, caregivers, physicians and networks.
• Monitor care plan effectiveness and document interventions.
• Promote service integration across LTSS and behavioral health.
• Assess medical necessity and authorize waiver services.
• Evaluate benefits and advise on funding sources.
• Coordinate ICT meetings for approval/denial of services.
• Use motivational interviewing and Molina guidelines to support change.
• Identify barriers and provide care coordination for psycho/social/financial obstacles.
• Identify critical incidents and develop prevention plans.
• Collaborate with licensed care managers as needed.
• 25-40% local travel may be required.

Skills

Healthcare experience

Care management

Communication skills

Travel readiness

Microsoft Office

Detail-oriented

Independent worker

Time management

Problem solving

Education

Bachelor's degree in healthcare

Clinical licensure/certification (if required)

Tools

Microsoft Office

Online portals & databases

Job description

Molina Healthcare is seeking a care coordination professional in Illinois to support LTSS-focused activities and collaborate with a multidisciplinary team to deliver high-quality, cost-effective member care.

Responsibilities include member assessments, care plan development, service integration, and travel as needed. The role emphasizes motivational interviewing and compliance with state contracts and regulations.