Molina Healthcare
Care Manager, LTSS - Field travel in Jefferson County, WI
Molina Healthcare, Madison, Wisconsin, us, 53774
Care Manager, LTSS - Field travel in Jefferson County, WI
Molina Healthcare
Overview Provides support for care management and coordination of long‑term services and supports, collaborating with a multidisciplinary team to coordinate integrated delivery of member care across the continuum for high‑need members. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy for quality and cost‑effective member care.
Responsibilities
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 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 casinos.
Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles.
Identifies critical incidents vieille and develops prevention plans to assure member health and welfare.
Collaborates with licensed care managers/leadership as needed or required.
Travel 25‑40% of time locally, as required by state/contractual requirements.
Required Qualifications
At least 2 years of health‑care experience, including at least 1 year working with people with disabilities/chronic conditions and long‑term services and supports (LTSS), and 1 year of experience in care management; or experience in a medical*)) 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.
In some states, a bachelor’s degree in a health‑care related field may be required (dependent upon state_squared requirements).
Valid and unrestricted driver’s license, reliable transportation and adequate auto insurance for job‑related travel requirements, unless otherwise required byHealth 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 beendet state of practice.
Experience working with populations that receive waiver services.
Pay Range Pay Range: $24 – $46.81 per hour. Actual compensation may vary based on geographic location, work experience, education and/or skill level.
Benefits Molina Healthcare offers a competitive benefits and compensation package.
Equal Opportunity Employer Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Contact To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Additional Information Referrals increase your chances of interviewing at Molina Healthcare by 2x.
#J-18808-Ljbffr
Overview Provides support for care management and coordination of long‑term services and supports, collaborating with a multidisciplinary team to coordinate integrated delivery of member care across the continuum for high‑need members. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy for quality and cost‑effective member care.
Responsibilities
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 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 casinos.
Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles.
Identifies critical incidents vieille and develops prevention plans to assure member health and welfare.
Collaborates with licensed care managers/leadership as needed or required.
Travel 25‑40% of time locally, as required by state/contractual requirements.
Required Qualifications
At least 2 years of health‑care experience, including at least 1 year working with people with disabilities/chronic conditions and long‑term services and supports (LTSS), and 1 year of experience in care management; or experience in a medical*)) 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.
In some states, a bachelor’s degree in a health‑care related field may be required (dependent upon state_squared requirements).
Valid and unrestricted driver’s license, reliable transportation and adequate auto insurance for job‑related travel requirements, unless otherwise required byHealth 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 beendet state of practice.
Experience working with populations that receive waiver services.
Pay Range Pay Range: $24 – $46.81 per hour. Actual compensation may vary based on geographic location, work experience, education and/or skill level.
Benefits Molina Healthcare offers a competitive benefits and compensation package.
Equal Opportunity Employer Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Contact To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Additional Information Referrals increase your chances of interviewing at Molina Healthcare by 2x.
#J-18808-Ljbffr