Lead Specialist, Functional Screening - Field travel in Iowa and Richland County, WI

Molina Healthcare•Long Beach, WI

About The Position

JOB DESCRIPTION Job Summary Provides lead level support for long-term care screening processes and coordination for older adults and adults with physical or intellectual disabilities. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties Monitors quality and accuracy of long-term care screening LTCFS processes including enrollment, annual screening, rescreen, and edits completed by certified functional screeners in screening regions. Tracks and ensures adherence to LTCFS timeframes. Reviews and tracks level of care and condition changes for members, including follow-up consultation with staff and managed care organization enrollment, eligibility, and fiscal staff as appropriate. Develops, implements, and monitors LTCFS training for new staff, existing staff, and mandatory adult screener continuing skills testing. Supports staff in multiple geographic service regions. Informs certified screeners of changes to LTCFS format and instructions. Coordinates and facilitates annual audits as well as ongoing quality assurance auditing to meet contractual requirements. Implements corrective action plans as required to address screener certification or qualification concerns. Conducts rescreens for members as needed for level of care determination or training purposes, allowing new/existing screeners to shadow lead screener and makes occasional home visits for this purpose. Responds to expedited requests by senior leadership, care management oversight division, and applicable regulators to review, audit, and report back on member screens. Maintains LTCFS certification by completing and passing required continuing skills testing. Local travel may be required (based upon state/contractual requirements).

Requirements

At least 3 years experience in health care, including at least 1 year of experience supporting adults with physical/intellectual disabilities or the frail elderly, and 1 year experience in a long-term care program, or equivalent combination of relevant education and experience.
Long-term functional screening (LTCFS) certification.
A bachelor’s degree in a social work, human services or health-related field, or Registered Nurse (RN) licensure may be required for certain states (dependent upon state/contractual requirements). If licensed, license must be active and unrestricted.
Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements.
Ability to support staff professional development, meet performance quotas and balance team dynamics and independent responsibilities.
Experience with data management, project coordination, and training.
Ability to explain and teach complex and detailed material in group and individual settings.
Excellent verbal and written communication skills.
Microsoft Office suite/applicable software program(s) proficiency.

Responsibilities

Monitors quality and accuracy of long-term care screening LTCFS processes including enrollment, annual screening, rescreen, and edits completed by certified functional screeners in screening regions.
Tracks and ensures adherence to LTCFS timeframes.
Reviews and tracks level of care and condition changes for members, including follow-up consultation with staff and managed care organization enrollment, eligibility, and fiscal staff as appropriate.
Develops, implements, and monitors LTCFS training for new staff, existing staff, and mandatory adult screener continuing skills testing.
Supports staff in multiple geographic service regions.
Informs certified screeners of changes to LTCFS format and instructions.
Coordinates and facilitates annual audits as well as ongoing quality assurance auditing to meet contractual requirements.
Implements corrective action plans as required to address screener certification or qualification concerns.
Conducts rescreens for members as needed for level of care determination or training purposes, allowing new/existing screeners to shadow lead screener and makes occasional home visits for this purpose.
Responds to expedited requests by senior leadership, care management oversight division, and applicable regulators to review, audit, and report back on member screens.
Maintains LTCFS certification by completing and passing required continuing skills testing.