Care Manager, LTSS - Field travel in Dodge and Fond du Lac County, WI

JOB DESCRIPTION
Family Care with My Choice Wisconsin
Job Summary
Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
* Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
* Facilitates comprehensive waiver enrollment and disenrollment processes.
* Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
* Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
* Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
* Assesses for medical necessity and authorizes all appropriate waiver services.
* Evaluates covered benefits and advises appropriately regarding funding sources.
* Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
* Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
* Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
* Identifies critical incidents and develops prevention plans to assure member health and welfare.
* Collaborates with licensed care managers/leadership as needed or required.
* 25-40% estimated local travel may be required (based upon state/contractual requirements).
Required Qualifications
* At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
* In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
* Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
* Demonstrated knowledge of community resources.
* Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
* Ability to operate proactively and demonstrate detail-oriented work.
* Ability to work independently, with minimal supervision and self-motivation.
* Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.
* Ability to develop and maintain professional relationships.
* Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
* Excellent problem-solving, and critical-thinking skills.
* Strong verbal and written communication skills.
* Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
* In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
Preferred Qualifications
* Certified Case Manager (CCM)
* Experience working with populations that receive waiver services.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $24 - $46.81 / HOURLY
* Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.