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Eligibility Assessment Specialist

2 months ago

Madison, Wisconsin, United States Molina Healthcare Full time
Job Overview

Position Summary

Molina Healthcare is seeking a dedicated Eligibility Screener who is passionate about making a difference in the lives of individuals. This role is ideal for those who thrive in a meaningful work environment and are committed to supporting community members in achieving their best quality of life.

This remote position involves engaging with individuals in your community who utilize the TMG IRIS Consultant Agency. While primarily home-based, the role includes regular visits to participants in their residences, ensuring that no two days are the same.

As an Eligibility Screener, your primary responsibility will be to conduct the Adult Long-Term Care Functional Screens (LTC-FS) for participants in the Wisconsin IRIS program, a Medicaid long-term care option tailored for older adults and individuals with disabilities. This includes performing annual rescreens and assessments for changes in condition to determine ongoing eligibility. The ideal candidate will exhibit approachability, compassion, and respect for diverse backgrounds and abilities, while effectively recognizing and articulating the inherent strengths of individuals.

Molina Healthcare values diversity and inclusion within its workforce and emphasizes the importance of work-life balance. Despite the remote nature of the position, you will receive ample support from your colleagues and the broader organization.

Key Responsibilities

  • Conduct face-to-face meetings with IRIS participants to facilitate the screening process.
  • Administer the Adult Long-Term Care Functional Screen (LTC-FS) in accordance with Wisconsin Adult LTC-FS guidelines.
  • Verify screening results through communication with IRIS Consultants, Medicaid Personal Care agencies, and healthcare providers as necessary.
  • Adhere to the highest standards of documentation and regulatory compliance, ensuring timely completion of assessments.
  • Enhance screening skills through participation in team meetings, training sessions, and ongoing professional development.
  • Perform additional duties as assigned by management.

Qualifications

Education:

Bachelor's Degree in health or human services or a related field (e.g., social work, psychology) or graduation from an accredited nursing program.

Experience and Skills:

  • Minimum of 1 year of experience working with target populations, including adults with physical or intellectual disabilities or older adults.
  • Excellent written and verbal communication skills, with a keen attention to detail.
  • Proficient in computer and software applications, particularly Microsoft Office Suite.
  • Strong customer service orientation.
  • Effective organizational and time management abilities.
  • Ability to work collaboratively within a team or independently.
  • Flexibility to adapt to changing organizational needs.
  • Willingness to travel as required (approximately 5%).

Licensure and Certification:

  • Must successfully complete the Wisconsin Adult Long-term Care Functional Screen certification modules (achieving 80% or higher) within the first week of employment and maintain certification.
  • If a graduate from an accredited nursing program, must hold an active, unrestricted Wisconsin Registered Nursing (RN) license in good standing.
  • Must possess a valid driver's license and maintain adequate auto insurance for job-related travel.

Preferred Qualifications:

Current or former certification in the Long-Term Care Functional Screen is advantageous.

Molina Healthcare offers a competitive benefits and compensation package, ensuring a supportive and rewarding work environment.