Care Manager, LTSS

Molina Healthcare • Texas, Texas • 4d 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

National Accounts Manager

MSC Industrial Supply Co. • Texas, Texas • 1h ago

Management & Administrative

BUILD A BETTER CAREER WITH MSC Serving customers and our community starts with the best people doing their best work. That is precisely what we have created at MSC Industrial Supply Co. We are a leading North American di...

1h ago

Go to Apply

Product Manager - Information Technology

United Airlines • Houston, TX • 1h ago

Management & Administrative

Achieving our goals starts with supporting yours. Grow your career, access top-tier health and wellness benefits, build lasting connections with your team and our customers, and travel the world using our extensive route...

1h ago

Go to Apply

VP, Account Management

RxBenefits • Houston, TX • 1h ago

Management & Administrative

The Vice President, Account Management is a mission critical role responsible for delivering on our client commitments, creating and maintaining strong customer relationships and increasing the RxBenefits share and footp...

1h ago

Go to Apply

Key Account Manager - Facilities Care Solutions

3M • Dallas, TX • 1h ago

Management & Administrative

Job Description: Key Account Manager - FCS Collaborate with Innovative 3Mers Around the World Choosing where to start and grow your career has a major impact on your professional and personal life, so it's equally import...

1h ago

Go to Apply

Key Account Manager - Facilities Care Solutions

3M • Austin, TX • 1h ago

Management & Administrative

1h ago

Go to Apply

Analyst, Account Management

CVS Health • Austin, TX • 1h 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...

1h ago

Go to Apply

Strategic Account Manager

Palo Alto Networks • Dallas, TX • 1h ago

Management & Administrative

Our Mission At Palo Alto Networks® everything starts and ends with our mission: Being the cybersecurity partner of choice, protecting our digital way of life. Our vision is a world where each day is safer and more secure...

1h ago

Go to Apply

Strategic Account Manager II

Valvoline Global • Dallas, TX • 1h ago

Management & Administrative

Job Purpose The Heavy-Duty Key Account Manager (KAM) is responsible for leading Valvoline's commercial relationships with major heavy-duty accounts across North America. This position drives profitable growth by developi...

1h ago

Go to Apply

Senior Partner Account Manager

Unity Technologies • Austin, TX • 1h ago

Management & Administrative

Remote, USA Senior Partner Account Manager Location Remote, USA Department Business Development & Sales Requisition ID JOBREQ-2515092 Role description The opportunity Unity is is on the look out for a highly experien...

1h ago

Go to Apply

Named Account Manager

Palo Alto Networks • Dallas, TX • 1h ago

Management & Administrative

1h 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.