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Care Manager, Ltss - Field Travel In Some Of Chippewa & Taylor Counties, Wi
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Molina Healthcare
Taylor, WI (In Person)
Full-Time
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Job Description
•Remote with field travel in Chippewa & Taylor Counties, WI for member visits•JOB DESCRIPTIONJob SummaryProvides 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.⢠•% 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.â¢Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). 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.⢠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)
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.⢠•% 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.â¢Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). 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.⢠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)