Long-Term Services and Supports Care Manager (RN) in Lindon, UT
Job Description
Job Summary
As a Long-Term Services and Supports Care Manager, you will play a crucial role in providing high-quality care coordination and management for members with complex needs. You will collaborate with a multidisciplinary team to ensure integrated delivery of care, helping members progress toward their desired outcomes while driving strategies for effective and cost-efficient care.
Essential Job Duties
• Conduct comprehensive member assessments, including necessary in-home visits within regulated timelines.
• Facilitate the waiver enrollment and disenrollment process effectively.
• Develop and implement care plans in collaboration with members, caregivers, healthcare professionals, and the member support network.
• Monitor ongoing care plans, documenting interventions and goal achievements, and suggesting necessary updates.
• Promote service integration for members, considering behavioral health and community resources to ensure continuity of care.
• Assess medical necessity and authorize appropriate waiver services.
• Evaluate coverage options and provide guidance on funding sources.
• Organize interdisciplinary care team meetings to discuss service approvals and facilitate collaboration.
• Utilize motivational interviewing techniques and clinical guidelines to support and educate members.
• Identify and address barriers to care, providing coordination to overcome psycho/social, financial, and medical challenges.
• Recognize critical incidents and develop plans to ensure member health and safety.
• Be prepared to provide consultation and recommendations to colleagues as needed.
• Handle complex member cases and conduct medication reconciliations when necessary.
• Anticipate local travel requirements of approximately 25-40%, depending on state regulations.
Required Qualifications
• Minimum of 2 years of healthcare experience, with at least 1 year in care management, managed care, or a medical/behavioral health setting.
• Proven experience working with individuals with disabilities, chronic conditions, or substance abuse issues.
• Active and unrestricted Registered Nurse (RN) license in your state.
• Valid driver's license, reliable transportation, and adequat auto insurance for work-related travel.
• Detail-oriented with the ability to operate proactively.
• Strong knowledge of community resources and capacity to work with diverse populations.
• Ability to work independently with minimal supervision.
• Responsive communication skills and calmness under pressure.
• Excellent time management, prioritization, problem-solving, and critical-thinking abilities.
• Proficient in Microsoft Office suite and relevant software applications.
• Experience working directly with individuals with substance use disorders is preferred in some states.
Preferred Qualifications
• Certified Case Manager (CCM) certification.
• Experience working with populations that utilize waiver services.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $26.41 - $51.49 per hour. Actual compensation may vary based on geographic location, work experience, education, and skill level.
As a Long-Term Services and Supports Care Manager, you will play a crucial role in providing high-quality care coordination and management for members with complex needs. You will collaborate with a multidisciplinary team to ensure integrated delivery of care, helping members progress toward their desired outcomes while driving strategies for effective and cost-efficient care.
Essential Job Duties
• Conduct comprehensive member assessments, including necessary in-home visits within regulated timelines.
• Facilitate the waiver enrollment and disenrollment process effectively.
• Develop and implement care plans in collaboration with members, caregivers, healthcare professionals, and the member support network.
• Monitor ongoing care plans, documenting interventions and goal achievements, and suggesting necessary updates.
• Promote service integration for members, considering behavioral health and community resources to ensure continuity of care.
• Assess medical necessity and authorize appropriate waiver services.
• Evaluate coverage options and provide guidance on funding sources.
• Organize interdisciplinary care team meetings to discuss service approvals and facilitate collaboration.
• Utilize motivational interviewing techniques and clinical guidelines to support and educate members.
• Identify and address barriers to care, providing coordination to overcome psycho/social, financial, and medical challenges.
• Recognize critical incidents and develop plans to ensure member health and safety.
• Be prepared to provide consultation and recommendations to colleagues as needed.
• Handle complex member cases and conduct medication reconciliations when necessary.
• Anticipate local travel requirements of approximately 25-40%, depending on state regulations.
Required Qualifications
• Minimum of 2 years of healthcare experience, with at least 1 year in care management, managed care, or a medical/behavioral health setting.
• Proven experience working with individuals with disabilities, chronic conditions, or substance abuse issues.
• Active and unrestricted Registered Nurse (RN) license in your state.
• Valid driver's license, reliable transportation, and adequat auto insurance for work-related travel.
• Detail-oriented with the ability to operate proactively.
• Strong knowledge of community resources and capacity to work with diverse populations.
• Ability to work independently with minimal supervision.
• Responsive communication skills and calmness under pressure.
• Excellent time management, prioritization, problem-solving, and critical-thinking abilities.
• Proficient in Microsoft Office suite and relevant software applications.
• Experience working directly with individuals with substance use disorders is preferred in some states.
Preferred Qualifications
• Certified Case Manager (CCM) certification.
• Experience working with populations that utilize waiver services.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $26.41 - $51.49 per hour. Actual compensation may vary based on geographic location, work experience, education, and skill level.
Job Details
Medical Speciality
Home HealthGeriatricsHospice & Palliative MedicinePublic health
Employment Type
Full-time
Required License
RN (Registered Nurse)
Work Setting
ClinicOutpatientLong term care
About Molina Healthcare
Molina Healthcare is a leading health care provider dedicated to improving the health and lives of its members. With over 30 years of experience, Molina specializes in delivering high-quality and affordable health care solutions. The company focuses on addressing the unique needs of its members by offering a range of services designed to promote overall well-being and access to essential health care. Molina's commitment to quality and affordability sets it apart in the industry, making it a trusted choice for many seeking comprehensive health care coverage.