Care Manager, Long-Term Services and Supports - Molina Healthcare : Job Details

Join our team as a Care Manager!

About the Role

Molina Healthcare Services (HCS) is seeking a dedicated Care Manager to work with our members, providers, and interdisciplinary teams to assess, plan, and coordinate integrated care for individuals with high-need potential. Your mission will be to facilitate quality, medically appropriate, and cost-effective care across behavioral health and long-term services and supports.

Key Responsibilities

• Conduct face-to-face comprehensive assessments of members within regulated timelines.
• Guide members through waivers enrollment and disenrollment processes.
• Create and implement individualized case management plans, collaborating with members, caregivers, and healthcare professionals to meet member needs.
• Monitor and evaluate care plans for effectiveness and ensure proper documentation of interventions and goal achievements.
• Foster the integration of services, enhancing continuity of care for our members.
• Assess medical necessity and authorize appropriate waiver services.
• Guide members regarding covered benefits and funding sources.
• Perform home visits as needed.
• Facilitate interdisciplinary care team meetings for service approvals.
• Utilize motivational interviewing techniques to empower and support members during consultations.
• Identify barriers to care and provide coordination to address psychosocial, financial, and medical challenges.
• Recognize critical incidents and develop prevention plans to ensure member safety and health.
• Please note that 50-75% of this role will involve local travel.

Qualifications

Required Education:

• Bachelor's or Master's degree in social sciences, psychology, gerontology, public health, or social work.

Required Experience:

• Minimum of 1 year working with individuals with disabilities or chronic conditions in Long-Term Services & Supports.
• 1-3 years of experience in case management, disease management, managed care, or medical/behavioral health settings.

Preferred Experience:

• 3-5 years in case management or related health settings.
• At least 1 year of experience working with populations receiving waiver services.

Preferred Licenses and Certifications:

• Active and unrestricted Certified Case Manager (CCM) certification.
• Active, unrestricted State Clinical Social Worker license in good standing.
• Valid driver's license with a clean driving record and reliable transportation.

State Specific Requirements:

For Wisconsin candidates: A Bachelor's degree (or higher) in human services with a minimum of one year experience working with Family Care target populations, or a Bachelor's degree in another area along with three years of experience in the same.

Why Join Molina?

Molina Healthcare offers a comprehensive benefits and compensation package. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $24 - $46.81 / HOURLY. Actual compensation may vary based on geographic location, work experience, education, and/or skill level.