Care Manager, LTSS- MUST Reside in ID
Molina Healthcare, New York, NY, United States
Job Summary
Provides support for care management/care coordination long‑term services and supports specific activities and collaborates with multidisciplinary teams 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 and 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
MUST RESIDE IN IDAHO state.
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 an equivalent combination of relevant education and experience.
Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required only if mandated by state contract, regulation, or board.
Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel.
Demonstrated knowledge of community resources.
Ability to work within a variety of settings, adjusting style as needed for diverse populations.
Proactive, detail‑oriented, and self‑motivated work ethic.
Excellent communication, time‑management, prioritization, and problem‑solving skills.
Strong verbal and written communication skills.
Proficiency in Microsoft Office and online portals.
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) with active, unrestricted license.
Experience working with populations that receive waiver services.
Benefits
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range
Pay Range: $21.6 – $46.81 / HOURLY
Actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level.
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Provides support for care management/care coordination long‑term services and supports specific activities and collaborates with multidisciplinary teams 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 and 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
MUST RESIDE IN IDAHO state.
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 an equivalent combination of relevant education and experience.
Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required only if mandated by state contract, regulation, or board.
Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel.
Demonstrated knowledge of community resources.
Ability to work within a variety of settings, adjusting style as needed for diverse populations.
Proactive, detail‑oriented, and self‑motivated work ethic.
Excellent communication, time‑management, prioritization, and problem‑solving skills.
Strong verbal and written communication skills.
Proficiency in Microsoft Office and online portals.
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) with active, unrestricted license.
Experience working with populations that receive waiver services.
Benefits
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range
Pay Range: $21.6 – $46.81 / HOURLY
Actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level.
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