Case Manager, Ltss

1 month ago


Janesville, United States Molina Healthcare Full time

Family Care with My Choice Wisconsin

Job Summary

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.

KNOWLEDGE/SKILLS/ABILITIES

Completes face-to-face comprehensive assessments of members per regulated timelines.

Facilitates comprehensive waiver enrollment and disenrollment processes.

Develops and implements a case management plan, including a waiver service plan, in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.

Performs ongoing monitoring of the 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, home and community to enhance the continuity of care for Molina members.

Assesses for medical necessity and authorize all appropriate waiver services.

Evaluates covered benefits and advise appropriately regarding funding source.

Conducts face-to-face or home visits as required.

Facilitates interdisciplinary care team 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, provides care coordination and assistance to member to address psycho/social, financial, and medical obstacles concerns.

Identifies critical incidents and develops prevention plans to assure member's health and welfare.

Provides consultation, recommendations and education as appropriate to non-RN case managers

Works cases with members who have complex medical conditions and medication regimens

Conducts medication reconciliation when needed.

50-75% travel required.

JOB QUALIFICATIONS

Required Education

Graduate from an Accredited School of Nursing

Required Experience

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.

Required License, Certification, Association

Active, unrestricted State Registered Nursing license (RN) in good standing

If field work is required, Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

State Specific Requirements

**Virginia**: Must have at least one year of experience working directly with individuals with Substance Use Disorders

Preferred Education

Bachelor's Degree in Nursing

Preferred Experience

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.

Preferred License, Certification, Association

Active and unrestricted Certified Case Manager (CCM)

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

PJHS
**Pay Range**: $23.76 - $51.49 / HOURLY
- Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.


  • Case Manager, LTSS

    2 days ago


    Janesville, United States Molina Healthcare Full time

    JOB DESCRIPTION Family Care with My Choice Wisconsin Job Summary 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...

  • Case Manager, LTSS

    11 hours ago


    Janesville, United States Molina Healthcare Full time

    JOB DESCRIPTION Family Care with My Choice Wisconsin Job Summary 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...

  • Case Manager, LTSS

    2 days ago


    Janesville, United States Molina Healthcare Full time

    Job DescriptionJOB DESCRIPTIONFamily Care with My Choice WisconsinJob SummaryMolina 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. ...


  • Janesville, United States Mercy Health System Full time

    Overview The Social Worker BSW coordinates and facilitates patient care activities to improve continuity of care across the health care continuum, to promote appropriate utilization of resources, and to contribute to improved patient satisfaction and outcomes. The BSW provides services and support to patients and families who are referred to Social Services...


  • Janesville, United States Mercy Health System Full time

    JOB REQUIREMENTS: Overview The Social Worker BSW coordinates and facilitates patient care activities to improve continuity of care across the health care continuum, to promote appropriate utilization of resources, and to contribute to improved patient satisfaction and outcomes. The BSW provides services and support to patients and families who are referred...


  • Janesville, United States Mercy Health System Full time

    Overview: Sign on Bonus up to 10,000! The Behavioral Health Case Manager works with the inpatient behavioral health/medicine multidisciplinary team to provide care for the patients admitted to those units. The BHCM would help with dispositional planning, care planning and group therapy. The BHCM also helps with behavioral health consults in the ED and on...


  • Janesville, United States Adara Home Health Full time

    Our Mission: Honoring PeopleOur Values: Integrity, Compassion, Curiosity, and HelpfulnessThe Licensed Practical Nurse furnishes comprehensive client care as assigned by the Case Manager in accordance with the Nurse Practice Act, the basic principles of practical nursing and the policies and procedures of the company. The LPN performs physical and...


  • Janesville, United States Adara Home Health Full time

    Our Mission: Honoring PeopleOur Values: Integrity, Compassion, Curiosity, and HelpfulnessThe Licensed Practical Nurse furnishes comprehensive client care as assigned by the Case Manager in accordance with the Nurse Practice Act, the basic principles of practical nursing and the policies and procedures of the company. The LPN performs physical and...


  • Janesville, United States Adara Home Health Full time

    Our Mission: Honoring PeopleOur Values: Integrity, Compassion, Curiosity, and HelpfulnessThe Licensed Practical Nurse furnishes comprehensive client care as assigned by the Case Manager in accordance with the Nurse Practice Act, the basic principles of practical nursing and the policies and procedures of the company. The LPN performs physical and...


  • Janesville, United States Mercyhealth (FKA Mercy Health System) Full time

    The critical thought leader we select for this important role will be accountable for identifying and promoting key strategies for continuously improving the outstanding quality and efficiency of care expected by our members. In addition to controlling costs through utilization management, case management, disease management and other strategies, this...


  • Janesville, United States Mercyhealth (FKA Mercy Health System) Full time

    The critical thought leader we select for this important role will be accountable for identifying and promoting key strategies for continuously improving the outstanding quality and efficiency of care expected by our members. In addition to controlling costs through utilization management, case management, disease management and other strategies, this...


  • Janesville, United States JusticePoint Full time

    The Pretrial Program Specialist plays an important role in the daily operations of JusticePoint. The Program Specialist will be trained in all program functions. The Program Specialist will primarily work in case management, with a focus on Electronic Monitoring (EM), but will assist in the Screening Program when there is a shortage. You will be the...


  • Janesville, United States Mercy Health System Full time

    JOB REQUIREMENTS: Overview This is a Pool or Flexible position for coverage of regulary scheduled partners within this department. This position may be asked to work at various locations within our health system. May be involved in Phase 1 Cardiac Rehabilitation by providing education and ambulation services to patients in the hospital setting. Responsible...

  • Merchandiser

    1 day ago


    Janesville, Wisconsin, United States PepsiCo Full time

    CLICK HERE to view our Merchandiser Realistic Job Preview Video Position is responsible for product merchandising within large volume stores (Grocery, etc.). This includes stocking shelves, rotating shelved product, setting up displays, stocking and rotating products in coolers, organizing and rotating products in storage rooms, and moving products from...

  • Janesville, WI

    1 day ago


    Janesville, United States Tekfortune Inc. Full time

    Job Description:We are seeking experienced Sterile Processing Tech; The candidates must have current Sterile Processing Certification through a nationally recognized organization is required. Tech must be fully vaccinated for COVID-19 and Flu.Cares for and reprocesses surgical instrumentation, including disassembly, decontamination, disinfection, inspection,...


  • Janesville, United States Rock County, WI Full time

    **Position Summary and Job Duties**: **Provide support and advocacy for clients who are seeking to overcome financial, personal health or family problems. Conduct informal individual and family assessments to assist clients in determining what services are needed. Provide linkage to resources and service providers. Work closely with neighborhood groups and...

  • Home Health LVN

    1 week ago


    Janesville, MN, United States Adara Home Health Full time

    The Licensed Practical Nurse furnishes comprehensive client care as assigned by the Case Manager in accordance with the Nurse Practice Act, the basic principles of practical nursing and the policies and procedures of the company. The LPN performs physical and psychological care, client and family education under the direction of a Registered Nurse Case...

  • Home Health LVN

    6 days ago


    Janesville, MN, United States Adara Home Health Full time

    The Licensed Practical Nurse furnishes comprehensive client care as assigned by the Case Manager in accordance with the Nurse Practice Act, the basic principles of practical nursing and the policies and procedures of the company. The LPN performs physical and psychological care, client and family education under the direction of a Registered Nurse Case...

  • Paralegal

    1 week ago


    Janesville, United States Hughes Resources Full time

    Job DescriptionJob DescriptionParalegal: Janesville, WIOur customer in Janesville, Wisconsin is seeking a motivated Paralegal to join their team and help grow their law firm. Responsibilities of the Paralegal:Assist attorneys and Paralegals in high volume case load. Paralegal Requirements and Qualifications:High level attention to detail.Good personal...


  • Janesville, United States United Alloy Full time

    United Alloy (UA) is the leading brand when to comes to metal fabrication and powder coating. UA produces the highest quality leak-proof metal fuel tanks, reservoirs, skids, frames, chassis, trailers, heavy metal fabrications, and complex weldments. At UA, our culture produces actively engaged people with sustainable results: safety, quality, productivity,...