Molina Healthcare
Care Manager, LTSS field care in Miami FL
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Care Manager, LTSS field care in Miami FL
role at
Molina Healthcare
Job Summary The Care Manager, LTSS provides support for care management and care coordination for long-term services and supports. The position collaborates with a multidisciplinary team to coordinate integrated delivery of member care across the continuum for members with high-need potential. The role ensures member progress toward desired outcomes and contributes to an overarching strategy to provide quality and cost-effective member care.
Job Description
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, collaborating with members, caregivers, physicians and other health professionals to address member needs and goals.
Performs ongoing monitoring of care plans 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 working with persons with disabilities or chronic conditions long-term services and supports (LTSS) and 1 year in care management or a related setting.
Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure required only if mandated by state contract or regulation.
Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance.
Demonstrated knowledge of community resources and ability to work with diverse populations.
Excellent time-management, problem-solving, critical-thinking, verbal and written communication, and Microsoft Office proficiency.
Preferred Qualifications
Certified Case Manager (CCM), LVN or LPN license active and unrestricted in state of practice.
Experience working with populations that receive waiver services.
Benefits and Compensation Pay Range: $24.00 – $46.81 hourly. Actual compensation may vary based on geographic location, work experience, education, and skill level. Molina Healthcare offers a competitive benefits and compensation package.
EEO Statement Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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Care Manager, LTSS field care in Miami FL
role at
Molina Healthcare
Job Summary The Care Manager, LTSS provides support for care management and care coordination for long-term services and supports. The position collaborates with a multidisciplinary team to coordinate integrated delivery of member care across the continuum for members with high-need potential. The role ensures member progress toward desired outcomes and contributes to an overarching strategy to provide quality and cost-effective member care.
Job Description
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, collaborating with members, caregivers, physicians and other health professionals to address member needs and goals.
Performs ongoing monitoring of care plans 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 working with persons with disabilities or chronic conditions long-term services and supports (LTSS) and 1 year in care management or a related setting.
Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure required only if mandated by state contract or regulation.
Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance.
Demonstrated knowledge of community resources and ability to work with diverse populations.
Excellent time-management, problem-solving, critical-thinking, verbal and written communication, and Microsoft Office proficiency.
Preferred Qualifications
Certified Case Manager (CCM), LVN or LPN license active and unrestricted in state of practice.
Experience working with populations that receive waiver services.
Benefits and Compensation Pay Range: $24.00 – $46.81 hourly. Actual compensation may vary based on geographic location, work experience, education, and skill level. Molina Healthcare offers a competitive benefits and compensation package.
EEO Statement Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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