Field Case Manager, LTSS

4 weeks ago

Canton, Ohio, United States Molina Healthcare Full time
{"Job Title": "Field Case Manager, LTSS", "Job Summary": "At Molina Healthcare, we are seeking a highly skilled and compassionate Field Case Manager to join our team. As a Field Case Manager, you will be responsible for completing face-to-face assessments with members in their homes, facilitating comprehensive waiver enrollment and disenrollment processes, and developing and implementing case management plans to address the unique needs and goals of each member.

**Key Responsibilities:**

* 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.

**Requirements:**

* Graduate from an Accredited School of Nursing
* 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.
* 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.

**Preferred Qualifications:**

* Bachelor's Degree in Nursing
* 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.
* Active and unrestricted Certified Case Manager (CCM)

**About Us:**

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. We are committed to making a difference in the lives of others and offer a competitive benefits and compensation package. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission.

**Job Type:**

Full Time

**Posting Date:**

09/04/2024

**Pay Range:**

$51.49 / HOURLY

**Equal Opportunity Employer:**

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

**Note:**

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

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