Case Manager, LTSS

Molina Healthcare-posted about 1 year ago
$97,365 - $97,365/Yr
Full-time • Entry Level
Insurance Carriers and Related Activities
Resume
Match Score
Upload and Match ResumeTrack Jobs with Teal

The Case Manager for Long-Term Services and Supports (LTSS) at Molina Healthcare is responsible for assessing, planning, and coordinating integrated care for members with high needs. This role involves working closely with members, providers, and multidisciplinary teams to ensure quality, medically appropriate, and cost-effective care across various settings, including behavioral health and long-term care.

  • Completes face-to-face comprehensive assessments of members per regulated timelines.
  • Facilitates comprehensive waiver enrollment and disenrollment processes.
  • Develops and implements a case management plan in collaboration with the member, caregiver, physician, and other healthcare professionals.
  • Performs ongoing monitoring of the care plan to evaluate effectiveness and suggest changes accordingly.
  • Promotes integration of services for members including behavioral health care and long-term services and supports.
  • Assesses for medical necessity and authorizes all appropriate waiver services.
  • Evaluates covered benefits and advises appropriately regarding funding sources.
  • Conducts face-to-face or home visits as required.
  • Facilitates interdisciplinary care team meetings for approval or denial of services.
  • Uses motivational interviewing to educate, support, and motivate change during member contacts.
  • Assesses for barriers to care and provides care coordination to address psycho/social, financial, and medical obstacles.
  • Identifies critical incidents and develops prevention plans to assure member's health and welfare.
  • Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or master's degree in a social science, psychology, gerontology, public health or social work OR any combination of education and experience that would provide an equivalent background.
  • At least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports.
  • 1-3 years in case management, disease management, managed care or medical or behavioral health settings.
  • 3-5 years in case management, disease management, managed care or medical or behavioral health settings.
  • 1 year experience working with population who receive waiver services.
  • Active and unrestricted Certified Case Manager (CCM) certification.
  • Active, unrestricted State Nursing license (LVN/LPN) OR Clinical Social Worker license in good standing.
  • Competitive pay range of $22.8 - $46.81 per hour.
  • Comprehensive benefits package including health insurance, dental insurance, and retirement plans.
Track Jobs with Teal

Job Search Resources

•
Resume Builder
•
Case Manager Resume Examples
•
Case Manager Cover Letter Examples

Tools

Career Hubs

Guides

Company

© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service