Waiver Coordination Specialist
2 weeks ago
POSITION SUMMARY
Molina Healthcare Services (HCS) collaborates with members, healthcare providers, and interdisciplinary team members to evaluate, facilitate, plan, and coordinate a comprehensive delivery of care across various settings, including behavioral health and long-term care, for individuals with significant care 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 conditions and the service environment.
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 process for Waiver services.
- Oversee the transition of Nursing Facility members in custodial care back to the community under the 'Money Follows the Person' initiative.
- Initiate referrals for Medicare and Waiver processes for members not already established in these programs.
- Track referrals and case documentation using designated state systems.
- Document activities within the transitional, assessment, and authorization processes, utilizing internal and state systems, and report findings to coordinators, supervisors, and the State agency.
- Ensure that Medicaid and Waiver eligibility have been requested and confirmed 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 assigned.
- Perform other administrative tasks as required.
QUALIFICATIONS
Education Requirements
High School Diploma or GED is required.
Experience Requirements
- 1-3 years of experience in an administrative support role within the healthcare sector.
- Proven ability to manage multiple tasks, prioritize effectively, and solve problems efficiently.
- Strong communication skills are essential.
Preferred Education
Associate degree is preferred.
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 offers 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.
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