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2h ago Curated

Care Manager, LTSS (RN) - Vinton County

Molina Healthcare

Job description

Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Completes comprehensive member assessments within regulated timelines, including in-person home visits. Facilitates waiver enrollment and disenrollment. Develops and implements care plans, performs ongoing monitoring, promotes integration of services, assesses for medical necessity, authorizes waiver services, evaluates covered benefits, facilitates interdisciplinary care team meetings, uses motivational interviewing, assesses for barriers to care, identifies critical incidents, and may conduct medication reconciliation. Requires 25-40% local travel.

Key responsibilities

  • Complete comprehensive member assessments including in-person home visits
  • Facilitate waiver enrollment and disenrollment processes
  • Develop and implement care plans in collaboration with members and healthcare professionals
  • Perform ongoing monitoring of care plan effectiveness
  • Promote integration of services including behavioral health and LTSS
  • Assess for medical necessity and authorize waiver services
  • Evaluate covered benefits and advise on funding sources
  • Facilitate interdisciplinary care team meetings
  • Use motivational interviewing to support member change
  • Assess for barriers to care and provide care coordination

What you bring

  • Active unrestricted RN license in state of practice
  • 2+ years healthcare experience including 1 year in care management/managed care/medical or behavioral health setting
  • 1+ year experience with persons with disabilities, chronic conditions, substance abuse disorders, and LTSS
  • Valid driver's license, reliable transportation, and auto insurance
  • Knowledge of community resources
  • Strong communication and problem-solving skills
  • Microsoft Office proficiency

Tags

Field-basedLTSSCare ManagementHome VisitsOhio

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