Licensed Social Worker Case Manager - Dayton OH

Molina Healthcare • Fort McKinley, OH

416d • $49,920 - $116,834

About The Position

The Licensed Social Worker Case Manager at Molina Healthcare will support the MMP Waiver Program by conducting assessments and coordinating care for members with high needs. This role requires excellent computer skills, attention to detail, and the ability to multitask effectively in a fast-paced environment. The position involves both telephonic and face-to-face interactions with members, ensuring they receive appropriate care and support.

Requirements

• 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.
• 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.

Nice To Haves

• 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.

Responsibilities

• Complete face-to-face comprehensive assessments of members per regulated timelines.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement a case management plan in collaboration with the member, caregiver, physician, and other healthcare professionals.
• Perform ongoing monitoring of the care plan to evaluate effectiveness and document interventions.
• Promote integration of services for members including behavioral health care and long-term services and supports.
• Assess for medical necessity and authorize all appropriate waiver services.
• Evaluate covered benefits and advise appropriately regarding funding sources.
• Conduct face-to-face or home visits as required.
• Facilitate interdisciplinary care team meetings for service approval or denial.
• Use motivational interviewing to educate and support members during contacts.
• Assess for barriers to care and provide coordination to address psycho/social, financial, and medical concerns.
• Identify critical incidents and develop prevention plans to assure member's health and welfare.

Benefits

• Competitive compensation package
• Mileage reimbursement for travel
• Health insurance coverage
• Paid time off
• Retirement savings plan

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Associate degree