JOB DESCRIPTION
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
- Serves as a community based member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing their healthcare needs.
- Collaborates with and supports the Healthcare Services team by providing non-clinical paraprofessional duties in the field, to include meeting with members in their homes, nursing homes, shelters, or doctor's offices, etc.
- Empowers members by helping them navigate and maximize their health plan benefits.
- Assistance may include : scheduling appointments with providers; arranging transportation for healthcare visits; getting prescriptions filled;
and following up with members on missed appointments.
- Assists members in accessing social services such as community-based resources for housing, food, employment, etc.
- Provides outreach to locate and / or provide support for disconnected members with special needs.
- Conducts research with available data to locate members Molina Healthcare has been unable to contact (e.g., reviewing internal databases, contacting member providers or caregivers, or travel to last known address or community resource locations such as homeless shelters, etc.)
- Participates in ongoing or project-based activities that may require extensive member outreach (telephonically and / or face-to-face).
- Guides members to maintain Medicaid eligibility and with other financial resources as appropriate.
- 50-80% local travel may be required. Reliable transportation required.
JOB QUALIFICATIONS
REQUIRED EDUCATION : HS Diploma / GED
HS Diploma / GED
REQUIRED EXPERIENCE :
Minimum 1 year experience working with underserved or special needs populations, with varied health, economic and educational circumstances.
REQUIRED LICENSE, CERTIFICATION, ASSOCIATION :
- Must have valid driver’s license with good driving record and be able to drive within applicable state or locality with reliable transportation.
- For Ohio and Florida only Active and unrestricted Community Health Worker (CHW) Certification.
PREFERRED EDUCATION :
Associate's Degree in a health care related field (e.g., nutrition, counseling, social work).
PREFERRED EXPERIENCE :
- Bilingual based on community need.
- Familiarity with healthcare systems a plus.
- Knowledge of community-specific culture.
- Experience with or knowledge of health care basics, community resources, social services, and / or health education.
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION :
- Current Community Health Worker (CHW) Certification preferred (for states other than Ohio and Florida, where it is required).
- Active and unrestricted Medical Assistant Certification
STATE SPECIFIC REQUIREMENTS : OHIO
- MHO Care Guide Plus serves as a single point of contact at Molina for care coordination when there is CCE, OhioRISE Plan, and / or CME involvement and short term care coordination needs are identified.
- Assures completion of a health risk assessment, assisting members to remediate immediate and acute gaps in care and access.
Assist members with filing grievances and appeals.
Connects members to CCEs, the OhioRISE Plan,or Molina Care Management if the members needs indicate a higher level of coordination.
Provide information to members related to Molina requirements , services and benefits .
Knowledge of internal MCO processes and procedures related to Care Guide responsibilities required
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.
Pay Range : $14.76 - $31.97 / HOURLY
Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance.
If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission.
Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package.
Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V.
Job Type : Full Time Posting Date : 06 / 21 / 2024
Community Connector-Spokane and surrounding counties
Serves as a community based member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing their healthcare needs. Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, ...
Community Organizer
The PJALS Community Organizer works with the PJALS membership and larger Spokane community to further our social justice agenda through activism, policy and legislation work, community education for action, and long-term organizing. Plan campaigns and hands-on organizing that inspires and motivates ...
Financial Advisor - Spokane / Eastern Washington / Coeur d'Alene / Northern Idaho and surrounding areas
Develop and maintain genuine, long-term relationships based on trust and understanding, with the ability to serve clients in your chosen community. We offer up to 24 weeks of paid training and coaching as you obtain your state insurance licenses (life, health & variable contracts), Series 7 and 66 r...
Fixed Site Peer Support Specialist (FT) Swing
As a member of the Integrated Case Management team, the peer support specialist provides clients with support, education, and community resource navigation to promote client recovery and self-sufficiency. This position is responsible for providing peer support services for households living in Catho...
Peer Support Specialist-Telehealth
Excelsior Wellness Center is looking for a Peer Support Specialist to join our VIEW telehealth program. As a Peer Support Specialist within the VIEW program, you play a crucial role in our mission to promote mental, emotional, and physical well-being in the community. Your role is to provide peer su...
Administrative Assistant
The Administrative Assistant will be responsible for performing various administrative and clerical tasks, such as organizing files, scheduling appointments, and managing correspondence. This is a part-time remote role for an Administrative Assistant at Walmart Global Tech/us. Prior experience in an...
Customer Service Representative.
Customer Service Representative. As a CSR, you will be responsible for delivering world-class customer service and technical expertise. Manage all customer communication on Service Projects. Coordinate all scheduling of Service Techs to support Service Projects. ...
Executive Assistants - Looking For Career Change
Make a commitment to grow dailyJohn C Maxwell.Are selfstarters with ambitiousfinancial goals.Aspire to elevate their professional success inan entrepreneurial capacity.As a candidate youllbe driven to achieve new heights of success eager to pursueadvanced training and development opportunities.Were ...
Customer Service Representative- Business Insurance
By handling a high volume of inbound calls from our existing customers, our Customer Service Representative is able to assist customers and agents with quotes, policy inquires and changes, address insurance billing questions or handle inquiries on technical support. Join the Travelers Team as a Cust...
Administrative Assistant- Multifamily Department
The person in this position is responsible for providing administrative support to the Multifamily Residential Department, as well as support to internal and external customers which includes accounting, management, property owners, community site team, residents, and vendors. Provide administrative...