Remote Care Manager: LTSS & Waiver Coordination

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

Job summary

Molina Healthcare Inc is seeking a care management professional to support LTSS activities and coordinate member care across teams. The role focuses on comprehensive assessments, care planning, and ensuring progress toward desired outcomes.

Involves collaboration with caregivers, physicians, and other health professionals. Responsibilities include monitoring plans, ensuring medical necessity, and coordinating with ICT for service approvals.

Qualifications

• At least 2 years health care experience, including LTSS.
• Experience in care management or medical/behavioral health setting.
• Valid driver’s license and reliable transportation.
• Knowledge of community resources.
• Strong communication and problem-solving skills.
• Proficiency with Microsoft Office and online portals.
• In some states, experience with individuals with substance use disorders.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians and others.
• Monitors care plan effectiveness and documents interventions and goals.
• Promotes integration of behavioral health and LTSS services.
• Assesses medical necessity and authorizes waiver services.
• Facilitates interdisciplinary care team meetings for approvals/denials.
• Uses motivational interviewing to support member change; addresses barriers to care.
• Identifies incidents and develops prevention plans to safeguard member health.
• 25-40% travel may be required for member visits.

Skills

Care coordination

Home visits

Communication skills

Time management

Microsoft Office

Travel readiness

Independent work

Education

Bachelor’s degree (healthcare)

Clinical licensure/certification (where required)

Tools

EHR / Electronic health records

Job description

Molina Healthcare Inc is seeking a care management professional to support LTSS activities and coordinate member care across teams. The role focuses on comprehensive assessments, care planning, and ensuring progress toward desired outcomes.

Involves collaboration with caregivers, physicians, and other health professionals. Responsibilities include monitoring plans, ensuring medical necessity, and coordinating with ICT for service approvals.