Care Coordination Specialist

2 weeks ago

MagstattleBas, Grand Est, United States Molina Healthcare Full time
Position Overview

Molina Healthcare Services (HCS) collaborates with members, healthcare providers, and interdisciplinary teams 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 healthcare needs.


The HCS team is dedicated to ensuring that patients achieve their desired health outcomes through high-quality care that is both medically appropriate and cost-effective, tailored to the severity of their conditions and the service environment.


Key Responsibilities

  • Conducts clinical evaluations of members within regulated timelines to identify eligibility for case management based on clinical insights, changes in health status, or psychosocial factors.
  • Creates and executes a personalized case management strategy in partnership with the member, their caregivers, healthcare providers, and support networks to meet the member's needs and objectives.
  • Engages in telephonic, in-person, or home visits as necessary.
  • Continuously monitors the effectiveness of the care plan, documenting interventions and progress towards goals, and recommending adjustments as needed.
  • Maintains an active caseload for regular follow-up and management.

Service Integration

  • Encourages the integration of services for members, including behavioral health and long-term support services, to improve continuity of care.
  • May implement specific wellness initiatives, such as asthma and depression management programs.
  • Facilitates interdisciplinary care team meetings and informal collaborations.
  • Utilizes motivational interviewing techniques and Molina clinical guidelines to educate and empower members during interactions.
  • Identifies barriers to care and provides coordination and support to address member concerns.
  • Collaborates with RN case managers and supervisors as necessary.
  • Case managers specializing in Behavioral Health and Social Sciences may offer consultation and resources to colleagues as required.
  • Local travel may be necessary, depending on the complexity of assigned cases and specific regulations.

Qualifications

Education:

Graduation from an accredited nursing program (LVN or LPN) or a Bachelor's or Master's degree in a relevant field such as social science, psychology, gerontology, public health, or social work.


Experience and Skills:
  • Minimum of 2 years in case management, disease management, or healthcare settings.
  • Experience working with individuals facing severe mental health challenges, including substance use disorders.
  • At least 2 years of experience in discharge planning across various care environments.
  • Strong verbal and written communication skills.
  • Proficient in data entry and experienced with clinical platforms.
  • Knowledge of behavioral health care principles and chronic condition management.
  • Proficient in Microsoft Office applications.
  • Experience with clinical documentation software.

Licensure:

Must hold an active, unrestricted license as a Master's level behavioral health therapist, such as LCSW, LPC, or LMFT.


Physical Requirements:

The work environment is generally favorable, with adequate lighting and temperature. The role may require prolonged periods of sitting. Reasonable accommodations will be made for individuals with disabilities to perform essential functions.


Company Overview

Molina Healthcare is committed to providing a competitive benefits and compensation package. We are an Equal Opportunity Employer (EOE) M/F/D/V.

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