Remote with travel throughout Chippewa and Eau Claire Counties, WI for member visitsJOB DESCRIPTION Job SummaryProvides support for care management/care coordination long-term services and supports (LTSS)-specific activities. 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 of 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.- Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, 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.- Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.- Problem-solving 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, must have at least one year of experience working directly with individuals with substance use disorders.Preferred Qualifications- Experience working with populations that receive waiver services.PJHSLI-AC1HTFTo 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: $24 - $46.81 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Care Manager, LTSS in milwaukee at Unknown Company
This position is listed as contract and able to be worked remotely.