Specialist, Waiver Support
Molina Healthcare is seeking a skilled Specialist to provide support for member waiver coordination activities. This role contributes to an interdisciplinary team that supports the integrated delivery of care across the continuum, driving a strategy to provide quality and cost‑effective member care.
Essential Job Duties
- Provides non‑clinical operational support for member waiver coordination processes.
- Facilitates communication between waiver coordination and the state program support unit.
- Receives initial state referrals for waiver services and works with long‑term services and supports (LTSS) to schedule initial assessment.
- Monitors status of initial member assessments, reassessments and transition assessments.
- Interfaces with state agency that determines eligibility for LTSS, to process and obtain approval of waiver services.
- Monitors transition process of nursing facility members in custodial beds to return to the community.
- Initiates referrals for Medicare and waiver process if member is not already Medicare or waiver established.
- Tracks referrals and case documents via designated state systems.
- Tracks activities occurring within the transitional, assessment and authorization processes – using internal systems and designated state systems, and reports results accordingly.
- Ensures Medicaid and waiver eligibility has been requested and received from state partners before transition/services are initiated.
- Maintains confidentiality and complies with Health Insurance Portability and Accountability Act (HIPAA).
- Attends internal meetings and regularly scheduled calls as assigned.
Required Qualifications
- At least 1 year of experience in an administrative support role in a health care setting, or equivalent combination of relevant education and experience.
- Ability to manage multiple work tasks and prioritize.
- Excellent problem‑solving skills.
- Strong verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs.
Preferred Qualifications
- Certified Medical Assistant (CMA).
- Long‑term care and/or managed care experience.
Molina Healthcare offers a competitive benefits and compensation package.
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $14.90 - $29.06 / HOURLY (Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level).
Seniority level: Entry level
Employment type: Full-time
Job function: Other
Industries: Hospitals and Health Care