Medicaid Care Navigator & Care Coordination

Molina Talent Acquisition; Midvale (UT); On-site; USD 55,000 - 75,000; Full time

Job summary

Molina Healthcare is seeking a Care Coordinator to review Utah Medicaid claims data, identify members who meet Restriction Program criteria, and support limited travel for in-state visits as needed.

The role manages an assigned caseload over a 12-month intervention period, coordinates care with providers, and ensures compliance with Utah Medicaid requirements while promoting quality outcomes and appropriate utilization of benefits.

Qualifications

• At least 2 years of health care experience in care management or equivalent.
• Clinical licensure and/or certification required only if state contract/regulation requires it.
• Valid driver's license, reliable transportation, and adequate auto insurance for job travel.
• Knowledge of community resources and ability to operate proactively.
• Strong verbal and written communication and time-management skills.
• Ability to work independently across diverse settings and populations.
• Proficiency with Microsoft Office and applicable software.
• Bachelor's degree in a health care related field may be required by contract.

Responsibilities

• Review Medicaid claims data to identify members meeting Restriction Program criteria.
• Manage a 12-month intervention caseload and provide care coordination.
• Coordinate with providers to implement lock-in assignments for provider/pharmacy.
• Conduct telephonic, in-person, or home visits as required.
• Monitor care plans, document interventions, and adjust as needed.
• Maintain ongoing member outreach and caseload management.
• Promote service integration across behavioral health, LTSS, and community resources.
• Facilitate interdisciplinary care team meetings and collaboration.
• Educate and motivate change using motivational interviewing and Molina guidelines.
• Identify barriers to care and assist members to address concerns.
• Collaborate with licensed care managers and leadership as required.
• Travel 25-40% based on state/contract requirements.

Skills

Care coordination

Communication

Time management

Problem solving

Travel readiness

Education

Bachelor's degree in health care

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Care Coordinator to review Utah Medicaid claims data, identify members who meet Restriction Program criteria, and support limited travel for in-state visits as needed.

The role manages an assigned caseload over a 12-month intervention period, coordinates care with providers, and ensures compliance with Utah Medicaid requirements while promoting quality outcomes and appropriate utilization of benefits.