Case Manager for Long-Term Services and Supports

2 weeks ago


Madison, Wisconsin, United States Molina Healthcare Full time

JOB SUMMARY

Molina Healthcare Services is seeking a dedicated Case Manager to work with members, providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate an integrated delivery of care across the continuum.

The ideal candidate will have at least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports, as well as 1-3 years in case management, disease management, managed care, or medical/behavioral health settings.

  • 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.
  • Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions, and goal achievement.
  • 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.

JOB QUALIFICATIONS

  • Graduate from an Accredited School of Nursing
  • Active, unrestricted State Registered Nursing license (RN) in good standing
  • 1-3 years in case management, disease management, managed care, or medical/behavioral health settings


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