Care Manager, LTSS - Big Bend - Molina Healthcare Careers

    Molina Healthcare Careers
    Molina Healthcare Careers Big Bend

    1 day ago

    Description
    JOB DESCRIPTION Job Summary

    Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential.

    Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

    Essential Job Duties


    • Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
    • Facilitates comprehensive waiver enrollment and disenrollment processes.
    • Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
    • Performs ongoing monitoring of 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 (LTSS) and home and community resources to enhance continuity of care.
    • Assesses for medical necessity and authorizes all appropriate waiver services.
    • Evaluates covered benefits and advises appropriately regarding funding sources.
    • Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
    • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
    • Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
    • Identifies critical incidents and develops prevention plans to assure member health and welfare.
    • Collaborates with licensed care managers/leadership as needed or required.
    • 25-40% estimated local travel may be required (based upon state/contractual requirements).
    Required Qualifications


    • At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
    • Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
    • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
    • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
    • Demonstrated knowledge of community resources.
    • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
    • Ability to operate proactively and demonstrate detail-oriented work.
    • Ability to work independently, with minimal supervision and self-motivation.
    • Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.
    • Ability to develop and maintain professional relationships.
    • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
    • Excellent problem-solving, and critical-thinking skills.
    • Strong verbal and written communication skills.
    • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
    • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
    Preferred Qualifications


    • Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice.
    • Experience working with populations that receive waiver services.

    To all current Molina employees:
    If you are interested in applying for this position, please apply through the Internal Job Board.

    Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
    #PJHS
    #HTF

    Pay Range:
    $24 - $46.81 / HOURLY
    *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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    Only for registered members

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    Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. · ...

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  • Work in company

    Care Manager, LTSS

    Only for registered members

    + Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. · + Strives to ensu ...

    Kenosha $24 - $46.81 (USD)

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