Manager, Case Manager

Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

Completes clinical assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in members health or psychosocial wellness, and triggers from the assessment.

Develops and implements a case management plan in collaboration with the member, caregiver, physician and / or other appropriate healthcare professionals and members support network to address the member needs and goals.

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

Maintains ongoing member case load for regular outreach and management.

Promotes integration of services for members including behavioral health care and long term services and supports to enhance the continuity of care for Molina members.

May implement specific Molina wellness programs i.e. asthma and depression disease management.

Facilitates interdisciplinary care team meetings and informal ICT collaboration.

Assesses for barriers to care, provides care coordination and assistance to member to address concerns.

Collaborates with RN case managers / supervisors as needed or required

Case managers in Behavioral Health and Social Science fields may provide consultation, resources and recommendations to peers as needed

Local travel may be required, depending on the complexity level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina’s Central Programs unit. Bachelors or Masters Degree (preferably in a social science, psychology, gerontology, public health or social work or related

1-3 years in case management, disease management, managed care or medical or behavioral health settings.

3-5 years in case management, disease management, managed care or medical or behavioral health settings.

Licensed Clinical Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education and Promotion (CHEP), Licensed Professional Counselor (LPC / LPCC), Respiratory Therapist, or Licensed Marriage and Family Therapist (LMFT).

47 / HOURLY

• Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.