<p>JOB DESCRIPTION Job Summary</p><p>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.<br><br></p><p>Essential Job Duties</p><p><br> • Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.<br> • Facilitates comprehensive waiver enrollment and disenrollment processes.<br> • 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.<br> • Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.<br> • 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.<br> • Assesses for medical necessity and authorizes all appropriate waiver services.<br> • Evaluates covered benefits and advises appropriately regarding funding sources.<br> • Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.<br> • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.<br> • Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.<br> • Identifies critical incidents and develops prevention plans to assure member health and welfare.<br> • Collaborates with licensed care managers/leadership as needed or required.<br> • 25-40% estimated local travel may be required (based upon state/contractual requirements).<br><br></p><p>Required Qualifications</p><p>• 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. </p><p>•Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.</p><p>• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).</p><p>• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.</p><p>• Demonstrated knowledge of community resources.</p><p>• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.</p><p>• Ability to operate proactively and demonstrate detail-oriented work.</p><p>• Ability to work independently, with minimal supervision and self-motivation.</p><p>• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.</p><p>• Ability to develop and maintain professional relationships.</p><p>• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.</p><p>• Excellent problem-solving, and critical-thinking skills.</p><p>• Strong verbal and written communication skills.</p><p>• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.</p><p>• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).<br><br><strong>Preferred Qualifications</strong></p><p>• Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice.<br> • Experience working with populations that receive waiver services.<br><br></p><p>To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.<br><br> Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V</p><p></p><p></p><p> Pay Range: $24 - $46.81 / HOURLY <br> Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.</p><img src="https://www.jobg8.com/Tracking.aspx?21Z5QEafrJdIIdv%2blFa0PbEq0maqasZiy" width="0" height="0" />