Care Manager, LTSS- (LSW, LCSW, LISW) - Hybrid - NE (Cleveland, OH)

JOB DESCRIPTION

Locations available : Cleveland, Toledo

Positions available : Care Management open for HCBS Waiver, Community Well and Nursing Facility

Job Summary

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.

KNOWLEDGE / SKILLS / ABILITIES

• Completes face-to-face comprehensive assessments of members per regulated timelines.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements a case management plan, including a waiver service plan, in collaboration with the member, caregiver, physician and / or other appropriate healthcare professionals and member's 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.
• Promotes integration of services for members including behavioral health care and long-term services and supports, home and community to enhance the continuity of care for Molina members.
• Assesses for medical necessity and authorize all appropriate waiver services.
• Evaluates covered benefits and advise appropriately regarding funding source.
• Conducts face-to-face or home visits as required.
• Facilitates interdisciplinary care team meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address psycho / social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member's health and welfare.
• 50-75% local travel required.

JOB QUALIFICATIONS

REQUIRED EDUCATION :

REQUIRED EXPERIENCE :

PREFERRED EXPERIENCE :

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION :

Active and unrestricted Certified Case Manager (CCM)

Active Licensed Social Worker, or Licensed Independent Social Worker in the state of Ohio.

Active, unrestricted State Nursing license (RN) OR Clinical Social Worker license in good standing

Valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation

STATE SPECIFIC REQUIREMENTS :

To all current Molina employees : If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V.

PJHS3

Pay Range : $24 - $46.81 / HOURLY