LTSS Care Navigator & Waiver Services

Jobtome; Brown Deer (WI); On-site; USD 33,000 - 64,000; Full time

Job summary

Molina Healthcare seeks a Care Manager to provide LTSS-focused care coordination and support. You will collaborate with a multidisciplinary team to ensure integrated member care and progress toward outcomes, while navigating waiver services and eligibility requirements.

The role includes conducting in-person assessments, developing and monitoring care plans, and coordinating with providers, caregivers, and the member’s support network. Some local travel is required.

Qualifications

• At least 2 years of health care experience, including 1 year with persons with disabilities/LTSS and 1 year in care management.
• Clinical licensure and/or certification required only if mandated by state contract or licensing mandates.
• In some states, a bachelor's degree in a health care related field may be required.
• Valid and unrestricted driver's license, reliable transportation, and auto insurance for job-related travel.
• Ability to work with diverse populations and independently with minimal supervision.
• Strong written and verbal communication skills.
• Proficiency with Microsoft Office and navigating online portals/databases.
• Experience with individuals with substance use disorders in some states may be required.

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 with members, caregivers, physicians and others.
• Monitors care plan effectiveness and documents interventions and goal achievement.
• Promotes integration of LTSS, behavioral health care, and community resources.
• Assesses medical necessity and authorizes waiver services.
• Facilitates interdisciplinary care team meetings for service approvals/denials.
• Uses motivational interviewing to educate and motivate change during member contacts.
• Assesses barriers to care and addresses psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans for member health.

Skills

Care management

LTSS experience

Disability/chronic condition care

Driver's license

Communication skills

Independent work

Time management

Motivational interviewing

Education

Bachelor's degree in health care

Tools

Microsoft Office

Online portals/databases

Job description

Molina Healthcare seeks a Care Manager to provide LTSS-focused care coordination and support. You will collaborate with a multidisciplinary team to ensure integrated member care and progress toward outcomes, while navigating waiver services and eligibility requirements.

The role includes conducting in-person assessments, developing and monitoring care plans, and coordinating with providers, caregivers, and the member’s support network. Some local travel is required.