Care Coordinator
5 days ago
Job Summary
Molina Healthcare Services (HCS) is seeking a skilled Care Coordinator to join our team. As a Care Coordinator, you will work with members, providers, and multidisciplinary teams 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.
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 suggests 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 authorizes all appropriate waiver services.
- Evaluates covered benefits and advises 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 members 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.
- 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 a valid driver's license with a good driving record and be able to drive within applicable state or locality with reliable transportation.
Preferred Qualifications
- Bachelor's Degree in Nursing.
- Years in case management, disease management, managed care, or medical or behavioral health settings.
- 1 year experience working with a population who receive waiver services.
- Active and unrestricted Certified Case Manager (CCM).
About Molina Healthcare
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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