Care Manager

Molina Healthcare•Long Beach, FL

11d

About The Position

Provides support for care management and care coordination activities and collaborates with a multidisciplinary team to coordinate integrated delivery of member care across the continuum. The role strives to ensure member progress toward desired outcomes and contributes to the strategy of providing quality, cost-effective member care. The position may require an estimated 25–40% local travel, depending on state and contractual requirements.

Requirements

At least 2 years of health care experience, preferably in care management or a medical and/or behavioral health setting, or an equivalent combination of relevant education and experience.
Clinical licensure and/or certification is required only when required by state contract, regulation, business operating model, or state board licensing mandates.
Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job-related travel, unless otherwise required by law.
Demonstrated knowledge of community resources.
Ability to work proactively and with attention to detail.
Ability to work across varied settings and adjust approach when working with diverse populations, personalities, and personal situations.
Ability to work independently with minimal supervision and demonstrate self-motivation.
Ability to respond through all forms of communication and remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Excellent time-management and prioritization skills, including the ability to manage multiple projects and adapt to change.
Excellent problem-solving and critical-thinking skills.
Strong verbal and written communication skills.
Proficiency with Microsoft Office suite and applicable software programs.
A bachelor's degree in a health care-related field may be required in some states, depending on state or contractual requirements.

Responsibilities

Complete member assessments within regulated timelines and determine eligibility for care coordination or care management based on assessment triggers.
Develop and implement care plans collaboratively with members, caregivers, physicians, other appropriate health care professionals, and member support networks.
Conduct telephonic, face-to-face, or home visits as required.
Monitor care plans on an ongoing basis, evaluate effectiveness, document interventions and goal achievement, and recommend changes as appropriate.
Maintain an ongoing member caseload and conduct regular outreach and management.
Promote integration of behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
Facilitate interdisciplinary care team (ICT) meetings and informal ICT collaboration.
Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate members during contacts.
Assess barriers to care and provide care coordination and assistance to address member concerns.
Collaborate with licensed care managers and leadership as needed or required.