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Molina Healthcare LTSS Care Coordinator in United States

KNOWLEDGE, SKILLS & ABILITIES(Generally, the occupational knowledge and specific technical and professional skills and abilities required to perform the essential duties of this job):

• Provides Long Term Services & Supports (LTSS) coordination services that align with the scope of work identified in the health plan's contract.

• Works collaboratively with Area Agencies on Aging (AAA) and/or state Medicaid agencies as appropriate to avoid interrupt or delay of a member's services.

• Performs care coordination activities in collaboration with health care providers, other HCS staff, involved medical case managers/care coordinators, public agencies, and other providers as required to provide timely and accurate service authorizations and integrated care.

• Conducts in-home assessments of a member's bio psychosocial and functional needs, as well as risk for poor health outcomes.

• Based on assessment results, member preference and Medicaid eligibility, develops individualized service plans and coordinates the provision of services.

• Documents all findings, contacts and interventions in the electronic care management system.

• Collaborates with state agencies, healthcare professionals and community support systems promote integrated care

• Provides in-home assessment and review of health needs, individualized service plans, and monitoring of Medicaid eligibility.

• Collaborates with Transition of Care Coach when discharge plan requires LTSS or in-home services.

• 40-50% local travel required.

JOB FUNCTION:

Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

REQUIRED EDUCATION:

Bachelor’s Degree in a health care related field; however, relevant experience will be considered in lieu of degree.

REQUIRED EXPERIENCE:

Min. 1 year clinical experience

PREFERRED EXPERIENCE:

• Experience in social services, medical terminology.

• Experience in managed care environment; including knowledge or applicable state and federal regulations and standards.

• Knowledge of social support systems, resource and basic case management principles.

PHYSICAL DEMANDS:

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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