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Waiver Coordination Specialist
2 months ago
POSITION SUMMARY
Molina Healthcare Services (HCS) collaborates with members, healthcare providers, and a multidisciplinary team to evaluate, facilitate, plan, and coordinate an integrated care delivery system. This encompasses both behavioral health and long-term care for members with significant needs. The HCS team is dedicated to ensuring that patients achieve their desired health outcomes through quality care that is both medically appropriate and cost-effective, tailored to the severity of their condition and the service location.
KEY RESPONSIBILITIES
- Provide operational support for Waiver coordination without clinical involvement.
- Enhance communication between Waiver coordinators and the state Program Support Unit.
- Receive initial State referrals for waiver services and collaborate with the Long-Term Services & Supports (LTSS) Coordinator to arrange initial assessments.
- Monitor the status of initial assessments, reassessments, and transition assessments for members.
- Engage with the State agency responsible for eligibility determinations and the LTSS Coordinator to facilitate the approval of Waiver services.
- Oversee the transition process for Nursing Facility members in custodial care to reintegrate them into the community under the 'Money Follows the Person' initiative.
- Initiate referrals for Medicare and Waiver processes for members who are not already established in these programs.
- Track referrals and case documentation using designated state systems.
- Document activities related to transitional, assessment, and authorization processes, reporting results to coordinators, supervisors, and the State agency.
- Ensure that Medicaid and Waiver eligibility requests are submitted and received from state partners prior to the initiation of transitions or services.
- Maintain confidentiality and adhere to the Health Insurance Portability and Accountability Act (HIPAA) regulations.
- Participate in internal meetings and scheduled calls as required.
- Perform additional administrative tasks as necessary.
QUALIFICATIONS
Required Education
High School Diploma or GED
Required Experience
- 1-3 years of experience in an administrative support role within the healthcare sector.
- Proven ability to manage multiple tasks, prioritize effectively, and demonstrate excellent problem-solving skills.
- Strong communication skills are essential.
Preferred Education
Associate Degree
Preferred Experience
- 3+ years of experience in an administrative support role in healthcare, with a preference for Medical Assistant experience.
- 2 years of experience in Long Term Care or Managed Care settings is preferred.
Molina Healthcare is committed to providing a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $29.06 / HOURLY
*Actual compensation may vary based on geographic location, work experience, education, and/or skill level.
