LTSS Field Care Manager - Care Coordination Pro

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

Job summary

Molina Healthcare seeks a Care Manager to support LTSS care coordination and multidisciplinary collaboration. You will conduct in-person assessments, coordinate waiver enrollment, and develop individualized care plans with members, caregivers, physicians, and the care network.

The role requires monitoring of plans, ensuring medical necessity, and navigating community resources. Expect travel and work across assigned counties with a focus on quality and cost-effective member care.

Qualifications

• Experience in health care with LTSS or disability-focused settings.
• Experience in care management or medical/behavioral health settings.
• Knowledge of community resources and care planning.

Responsibilities

• Complete assessments within regulated timelines, including home visits.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with members and care network.
• Monitor and document progress; adjust care plans as needed.
• Promote LTSS integration with behavioral health and home resources.
• Assess medical necessity and authorize waiver services.
• Evaluate benefits and funding sources for services.
• Facilitate ICT meetings for approval/denial of services.
• Use motivational interviewing to educate and motivate change.
• Identify barriers and provide coordination for psycho/social, financial, and medical needs.
• Identify critical incidents and develop prevention plans.
• Collaborate with licensed care managers as required.
• 25–40% local travel may be required.

Skills

Care coordination

Multidisciplinary collaboration

Motivational interviewing

Regulatory knowledge

Time management

Communication (verbal/written)

Microsoft Office

Travel readiness

Education

Bachelor's degree in health care related field

CCM certification preferred

LVN/LPN license preferred

Tools

Microsoft Office

Job description

Molina Healthcare seeks a Care Manager to support LTSS care coordination and multidisciplinary collaboration. You will conduct in-person assessments, coordinate waiver enrollment, and develop individualized care plans with members, caregivers, physicians, and the care network.

The role requires monitoring of plans, ensuring medical necessity, and navigating community resources. Expect travel and work across assigned counties with a focus on quality and cost-effective member care.