A Nursing Home or Home Health Administrator manages staff and operations at a long term care facility. Oversees admission and care of residents, staff hiring, billing and finances, compliance with regulatory requirements and building maintenance. Maintains professional licensing requirements. Manages staff, recordkeeping, billing, finances, and other administrative work for a home health care program, where aides assist clients with personal, household and some health-related services in their homes.
As a Care Manager specializing in Long-Term Services and Supports (LTSS), you will provide support for care management/care coordination LTSS-specific activities. You will play a crucial role in coordinating and managing comprehensive care for members with high-need potential, collaborating with a multidisciplinary team coordinating integrated delivery of member care across the continuum. This role strives to ensure member progress toward desired outcomes and contributes to the overarching strategy to provide quality and cost-effective member care. It involves completing assessments, developing care plans, and facilitating services to enhance continuity of care.
Your Impactful Responsibilities:
Complete comprehensive member assessments, including required in-person home visits, within regulated timelines. Facilitate comprehensive waiver enrollment and disenrollment processes. Develop and implement individualized care plans, including waiver service plans, in collaboration with members, caregivers, physicians, and other healthcare professionals. Perform ongoing monitoring of care plans to evaluate effectiveness, document interventions, and recommend necessary changes. Promote the integration of services, including behavioral health care, LTSS, and community resources, to ensure continuity of care. Assess for medical necessity and authorize appropriate waiver services. Evaluate covered benefits and provide guidance on funding sources. Facilitate interdisciplinary care team (ICT) meetings for service approval/denial and informal ICT collaboration. Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate change during member interactions. Assess and address barriers to care, providing coordination and assistance for psycho/social, financial, and medical obstacles. Identify critical incidents and develop prevention plans to safeguard member health and welfare. May provide consultation, resources and recommendations to peers as needed. Why Join Our Team? Molina Healthcare offers a competitive benefits and compensation package. We provide a supportive work environment where your contributions are valued, and you have the opportunity to make a significant impact on the lives of individuals needing long-term care and behavioral health support.
Who We're Looking For:
We are seeking a dedicated and experienced professional with at least two years of healthcare experience, including one year in care management, managed care, or a medical/behavioral health setting. You should have at least one year of experience working with individuals with disabilities, chronic conditions, substance abuse disorders, and LTSS, or an equivalent combination of relevant education and experience. In some states, you must have at least one year of experience working directly with individuals with substance use disorders. A valid and unrestricted professional license (LCSW, LMSW, APSW, CHES, LPC, LPCC, LMFT, PhD, or PsyD) in your state of practice is essential, and in some states, a bachelor's degree in a health care related field may be required. A valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel are required. The ideal candidate will possess strong verbal and written communication skills, problem-solving skills, and time-management and prioritization skills, with the ability to operate proactively and demonstrate detail-oriented work. You should be able to work independently with minimal supervision, be responsive in all forms of communication, remain calm in high-pressure situations, and develop and maintain professional relationships. The ability to work within a variety of settings and adjust style as needed, working with diverse populations and various personalities and personal situations, is key. Knowledge of community resources and proficiency in Microsoft Office are also required. Preferred qualifications include Certified Case Manager (CCM) and experience working with populations that receive waiver services. This is a Full Time position with 25-40% estimated local travel. Care Manager, LTSS (BH Licensed) - Join Our Team! Join our team as a Care Manager, LTSS (BH Licensed) and provide vital support for long-term services and supports. You'll collaborate with a multidisciplinary team to coordinate integrated care, ensuring members achieve desired outcomes. Make a real difference in the lives of individuals with high-need potential across the state.
