Case Manager, LTSS - La Crosse, WI, United States - Molina Healthcare

Description

Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.

HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

Develops and implements a case management plan, including a waiver service plan, in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.

~ Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
~ Promotes integration of services for members including behavioral health care and long-term services and supports, home and community to enhance the continuity of care for Molina members.
~ Assesses for medical necessity and authorize all appropriate waiver services.
~ Facilitates interdisciplinary care team meetings for approval or denial of services and informal ICT collaboration.
~ Assesses for barriers to care, provides care coordination and assistance to member to address psycho/social, financial, and medical obstacles concerns.
~ 50-75% local travel required.

Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or master's degree in a social science, psychology, gerontology, public health or social work OR any combination of education and experience that would provide an equivalent background

At least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports.
~1-3 years in case management, disease management, managed care or medical or behavioral health settings.

3-5 years in case management, disease management, managed care or medical or behavioral health settings.
~Active, unrestricted State Nursing license (LVN/LPN) OR Clinical Social Worker license in good standing
81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.