Waiver Coordination Specialist
1 week ago
POSITION SUMMARY
Molina Healthcare Services (HCS) collaborates with members, healthcare providers, and a multidisciplinary team to evaluate, facilitate, plan, and coordinate a comprehensive delivery of care across various services, including behavioral health and long-term care, for individuals with significant 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 condition and the service location.
ESSENTIAL KNOWLEDGE/SKILLS/ABILITIES
- Deliver non-clinical operational assistance for Waiver coordination.
- Enhance communication between Waiver coordinators and the state Program Support Unit.
- Handle initial State referrals for waiver services and collaborate with the Long-Term Services & Supports (LTSS) Coordinator to arrange the initial assessment.
- Oversee 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 process and secure approval for Waiver services.
- Supervise the transition process for Nursing Facility members in custodial care to reintegrate them into the community under the 'Money Follows the Person' initiative.
- Initiate referrals for Medicare and Waiver processes if the member is not already established in these programs.
- Maintain records of referrals and case documentation using designated state systems.
- Monitor activities within the transitional, assessment, and authorization processes, utilizing internal and designated state systems, and report findings to coordinators, supervisors, and the State agency.
- Ensure that Medicaid and Waiver eligibility requests are submitted and received from state partners prior to the initiation of transitions or services.
- Uphold confidentiality and adhere to the Health Insurance Portability and Accountability Act (HIPAA) regulations.
- Participate in internal meetings and regularly scheduled calls as required.
- Perform other administrative duties as necessary.
QUALIFICATIONS
Required Education
High School Diploma or GED
Required Experience
- 1-3 years of experience in an administrative support capacity within the healthcare sector.
- Proven ability to manage multiple tasks, prioritize effectively, and demonstrate excellent problem-solving skills.
- Strong communication skills are essential.
Preferred Education
Associate Degree
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 provides 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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