LTSS Care Navigator & Waiver Coordinator

Molina Healthcare; Prairie du Chien (WI); On-site; USD 52,000 - 76,000; Full time

Job summary

Molina Healthcare is seeking a Care Manager to support LTSS-focused care coordination and member outcomes. You will collaborate with a multidisciplinary team to deliver integrated care across the continuum and ensure quality, cost-effective member care.

The role includes in-person home visits, waiver enrollment processes, care plan development, and ongoing monitoring. Travel up to 40% may be required, with licensing requirements depending on state contracts.

Qualifications

• Two years of health care experience with LTSS focus and care management exposure.
• Knowledge of community resources and ability to work across diverse settings.

Responsibilities

• Provides care management support across LTSS for high-need members.
• Completes member assessments and coordinates waiver enrollment/disenrollment.
• Develops and documents care plans with input from members, caregivers, physicians, and support network.
• Monitors progress, evaluates outcomes, and adjusts plans as needed.
• Promotes coordination of behavioral health with LTSS and community resources.
• Assesses medical necessity and authorizes waiver services.
• Leads or participates in ICT meetings for service approvals.
• Uses motivational interviewing to educate and motivate member changes.
• Identifies barriers to care and assists with psycho/social and financial obstacles.
• Collaborates with licensed care managers and leadership as needed.
• Travel 25-40% may be required.

Skills

Care management

LTSS

Disabilities experience

Communication

Interdisciplinary collaboration

Time management

Problem solving

Detail oriented

Self motivation

Travel readiness

Education

Bachelor's degree in healthcare

Licensure/certification (where required)

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Care Manager to support LTSS-focused care coordination and member outcomes. You will collaborate with a multidisciplinary team to deliver integrated care across the continuum and ensure quality, cost-effective member care.

The role includes in-person home visits, waiver enrollment processes, care plan development, and ongoing monitoring. Travel up to 40% may be required, with licensing requirements depending on state contracts.