Molina Healthcare
Care Manager, LTSS - Field travel in Jefferson County, WI
Molina Healthcare, Watertown, Wisconsin, United States, 53094
Care Manager, LTSS - Field travel in Jefferson County, WI
Provide support for care management / care coordination for long‑term services and supports (LTSS). Collaborate with a multidisciplinary team to coordinate integrated delivery of member care across the continuum for members with high‑need potential. Strive to ensure member progress toward desired outcomes and contribute to overarching strategy to provide quality and cost‑effective member care.
Responsibilities
Complete comprehensive member assessments within regulated timelines, including in‑person home visits as required.
Facilitate comprehensive waiver enrollment and disenrollment processes.
Develop and implement 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 member needs and goals.
Perform ongoing monitoring of care plans to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
Promote 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.
Assess for medical necessity and authorize all appropriate waiver services.
Evaluate covered benefits and advise appropriately regarding funding sources.
Facilitate interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
Use motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
Assess for barriers to care and provide care coordination and assistance to members to address psycho/social, financial, and medical obstacles and concerns.
Identify critical incidents and develop prevention plans to assure member health and welfare.
Collaborate with licensed care managers/leadership as needed or required.
Travel locally 25‑40% of the time (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 or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
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.
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.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $24 - $46.81 / 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 Health Care Provider
Industries: Hospitals and Health Care
Referrals increase your chances of interviewing at Molina Healthcare by 2x.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Get notified about new Care Manager jobs in
Watertown, WI .
#J-18808-Ljbffr
Responsibilities
Complete comprehensive member assessments within regulated timelines, including in‑person home visits as required.
Facilitate comprehensive waiver enrollment and disenrollment processes.
Develop and implement 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 member needs and goals.
Perform ongoing monitoring of care plans to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
Promote 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.
Assess for medical necessity and authorize all appropriate waiver services.
Evaluate covered benefits and advise appropriately regarding funding sources.
Facilitate interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
Use motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
Assess for barriers to care and provide care coordination and assistance to members to address psycho/social, financial, and medical obstacles and concerns.
Identify critical incidents and develop prevention plans to assure member health and welfare.
Collaborate with licensed care managers/leadership as needed or required.
Travel locally 25‑40% of the time (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 or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
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.
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.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $24 - $46.81 / 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 Health Care Provider
Industries: Hospitals and Health Care
Referrals increase your chances of interviewing at Molina Healthcare by 2x.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Get notified about new Care Manager jobs in
Watertown, WI .
#J-18808-Ljbffr