LTSS Care Navigator — Integrated Care & Outcomes

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

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare in Rockford, IL is seeking a Care Management Specialist to support LTSS activities and coordinate member care across the continuum. You will work with a multidisciplinary team to ensure progress toward outcomes while optimizing care quality and cost efficiency.

Responsibilities include waiver enrollment, care plan development, ongoing monitoring, and collaboration with licensed care managers.

Qualifications

• Minimum 2 years health care experience including LTSS exposure.
• 1 year in care management or equivalent health/behavioral health setting.
• Proficiency with Microsoft Office and online portals.

Responsibilities

• Completes comprehensive member assessments within timelines, including home visits if needed.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members and care network.
• Monitors care plan effectiveness and suggests changes.
• Promotes integration of LTSS with behavioral health and community resources.
• Assesses medical necessity and authorizes waiver services.
• Collaborates with ICT meetings for service approvals/denials.

Skills

Healthcare experience

Disability/ LTSS exposure

Communication skills

Tools

Microsoft Office

Job description

Molina Healthcare in Rockford, IL is seeking a Care Management Specialist to support LTSS activities and coordinate member care across the continuum. You will work with a multidisciplinary team to ensure progress toward outcomes while optimizing care quality and cost efficiency.

Responsibilities include waiver enrollment, care plan development, ongoing monitoring, and collaboration with licensed care managers.