Care Manager, LTSS

Molina Healthcare • Vancouver, WA • 8h 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

Vendor Performance Manager

U.S. Bank • Gresham, OR • 3h ago

Management & Administrative

At U.S. Bank, we're on a journey to do our best. Helping the customers and businesses we serve to make better and smarter financial decisions and enabling the communities we support to grow and succeed. We believe it tak...

3h ago

Go to Apply

Customer Service - Self Storage Manager

Public Storage • Milwaukie, OR • 3h ago

Management & Administrative

Company Description Public Storage is the self-storage industry leader and we are Hiring Now! Earn $17.50 Per Hour Our Benefits Total Rewards package available to our team: We work Flexible and Full-Time Schedules betwee...

3h ago

Go to Apply

Customer Service - Self Storage Manager

Public Storage • Lake Oswego, OR • 3h ago

Management & Administrative

3h ago

Go to Apply

Central Procurement Intern

Pacific Seafood • Clackamas, OR • 16h ago

Management & Administrative

Pacific Seafood offers a unique, 13-week internship program that gives interns the chance to make an immediate impact on our company. Starting with a structured orientation week at our corporate headquarters near Portlan...

16h ago

Go to Apply

Customer Service Representative

Robert Half • Clackamas, OR • 1d ago

Management & Administrative

Description Do you possess excellent communication abilities and strong data entry skills? Robert Half is seeking personable Customer Service Representatives to assist our client's ongoing needs in the area. The Customer...

1d ago

Go to Apply

Administrative Assistant

Robert Half • Tualatin, OR • 1d ago

Management & Administrative

Description Do you possess excellent organizational skills and enjoy working in a fast-paced environment? Robert Half is seeking Administrative Assistants to support our clients' frequent needs in the area. The Administr...

1d ago

Go to Apply

Administrative Assistant

ManpowerGroup • Clackamas, OR • 1d ago

Management & Administrative

Our client, a leading organization in the distribution and logistics industry, is seeking a dedicated and proactive Administrative Assistant - Shift 1 to join their team. As an Administrative Assistant - Shift 1, you wil...

1d ago

Go to Apply

Administrative Assistant III

Kelly Services • Hillsboro, OR • 1d ago

Management & Administrative

Administrative Assistant III Location: Hillsboro, OR 97124 Pay Rate : $34.28/hr | Contract : 12 months | Schedule : Mon-Fri, onsite (PDX), some after-hours Seeking a proactive, organized Administrative Assistant to suppo...

1d ago

Go to Apply

11678- Project Manager 2 (Engineering)

Actalent • Vancouver, WA • 1d ago

Management & Administrative

Job Title: Project Manager 2 (Engineering)Job Description Join the Transmission Project Management organization as a Project Manager 2 (Engineering) to facilitate infrastructure projects from inception to completion. You...

1d ago

Go to Apply

Salesforce Configure, Price, Quote (CPQ) Senior Consultant

Deloitte • Portland, OR • 1d ago

Management & Administrative

Configure, Price, Quote (CPQ) Senior Consultant - Salesforce Our Deloitte Customer team empowers organizations to build deeper relationships with customers through innovative strategies, advanced analytics, Generative AI...

1d 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.