Care Manager, LTSS

Molina Healthcare • West Valley City, UT • 7h ago

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 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

Pay Range: $25.2 - $56.17 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Similar Jobs

Operations Manager

CVS Health • South Jordan, UT • 43min ago

Management & Administrative

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions compan...

43min ago

Go to Apply

Senior Manager, Commercial Market Development

Fujifilm • Salt Lake City, UT • 4h ago

Management & Administrative

Position Overview The primary responsibility of the Senior Manager, Commercial Market Development, ESD will be to establish new business relationships and partnerships through the US. This will be accomplished through th...

4h ago

Go to Apply

Care Manager, LTSS

Molina Healthcare • Salt Lake City, UT • 7h ago

Management & Administrative

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 memb...

7h ago

Go to Apply

Care Manager, LTSS

Molina Healthcare • West Valley City, UT • 7h ago

Management & Administrative

7h ago

Go to Apply

Global BD Excellence Senior Manager - Factory Flow

BD (Becton, Dickinson and Company) • Sandy, UT • 14h ago

Management & Administrative

Job Description Summary This position represents a fantastic opportunity for a talented, highly motivated, and positive individual to become a proactive member of BD's global Operational Excellence (OPEX) community. Repo...

14h ago

Go to Apply

Associate Pro Services Consultant

JobNimbus • Lehi, UT • 16h ago

Management & Administrative

We are obsessed with the hero's journey at JobNimbus. Every person has a hero's journey. Hermione Granger, James T. Kirk, Frodo Baggins, Anna & Elsa, Nacho Libre, and even YOU! This is our "call to adventure" to come...

16h ago

Go to Apply

Professional Services Consultant

JobNimbus • Lehi, UT • 16h ago

Management & Administrative

16h ago

Go to Apply

National Sales Manager

HENRY SCHEIN, INC. • American Fork, UT • 22h ago

Management & Administrative

This opportunity is remote within the United States. This position is responsible for the overall success and growth of large business segments operating under the Henry Schein One umbrella. Provide strategic sales direc...

22h ago

Go to Apply

Part Sales Manager - Full Time

AutoZone, Inc. • Stansbury Park, UT • 22h ago

Management & Administrative

Job Description AutoZone's Store Management team drives store performance, fosters a productive team, and ensures exceptional customer service. Managers and MITs play a key leadership role, expected to Live The Pledge an...

22h ago

Go to Apply

Part Sales Manager - Part Time

AutoZone, Inc. • Tooele, UT • 22h ago

Management & Administrative

22h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.