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JOB 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 Dutiesâ¢ Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.â¢ Facilitates comprehensive waiver enrollment and disenrollment processes.â¢ 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.â¢ Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.â¢ 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.â¢ Assesses for medical necessity and authorizes all appropriate waiver services.â¢ Evaluates covered benefits and advises appropriately regarding funding sources.â¢ Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.â¢ Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.â¢ Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.â¢ Identifies critical incidents and develops prevention plans to assure member health and welfare.â¢ Collaborates with licensed care managers/leadership as needed or required.â¢ •% estimated local travel may be required (based upon state/contractual requirements).Required Qualificationsâ¢ 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.â¢ 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.â¢ In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).â¢ Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.â¢ Demonstrated knowledge of community resources.â¢ Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.â¢ Ability to operate proactively and demonstrate detail-oriented work.â¢ Ability to work independently, with minimal supervision and self-motivation.â¢ Ability to demonstrate responsiveness in all forms of communication and remain calm in high-pressure situations.â¢ Ability to develop and maintain professional relationships.â¢ Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.â¢ Problem-solving skills.â¢ Strong verbal and written communication skills.â¢ Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.â¢ In some states, must have at least one year of experience working directly with individuals with substance use disorders.

Preferred Qualificationsâ¢ Certified Case Manager (CCM)â¢ Experience working with populations that receive waiver services.#PJHS#LI-AC1To 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/VPay Range:

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JOB DESCRIPTION

Essential Job Dutiesâ¢ Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.â¢ Facilitates comprehensive waiver enrollment and disenrollment processes.â¢ 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.â¢ Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.â¢ 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.â¢ Assesses for medical necessity and authorizes all appropriate waiver services.â¢ Evaluates covered benefits and advises appropriately regarding funding sources.â¢ Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.â¢ Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.â¢ Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.â¢ Identifies critical incidents and develops prevention plans to assure member health and welfare.â¢ Collaborates with licensed care managers/leadership as needed or required.â¢

•% estimated local travel may be required (based upon state/contractual requirements).Required Qualificationsâ¢ 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.â¢ 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.â¢ In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).â¢ Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.â¢ Demonstrated knowledge of community resources.â¢ Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.â¢ Ability to operate proactively and demonstrate detail-oriented work.â¢ Ability to work independently, with minimal supervision and self-motivation.â¢ Ability to demonstrate responsiveness in all forms of communication and remain calm in high-pressure situations.â¢ Ability to develop and maintain professional relationships.â¢ Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.â¢ Problem-solving skills.â¢ Strong verbal and written communication skills.â¢ Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.â¢ In some states, must have at least one year of experience working directly with individuals with substance use disorders.

Preferred Qualificationsâ¢ Certified Case Manager (CCM)â¢ Experience working with populations that receive waiver services.#PJHS#LI-AC1To 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/VPay Range:

$24 - $

•/ HOURLY

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

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Find & Apply For Nursing Home / Home Health Administrator Jobs in Viroqua, Wisconsin

Care Manager, Ltss - Field Travel In Crawford And Vernon County, Wi