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Added 7 hours ago
Clinical Validation Reviewer (RN) - Inpatient Coding & Reimbursement
Molina Talent Acquisition
United States
Added 7 hours ago
Senior Analyst, Business (Enrollment)
Molina Talent Acquisition
United States
Added 10 hours ago
Health Plan Provider Relations Manager (Michigan)
Molina Talent Acquisition
Detroit, MI · Flint, MI · Grand Rapids, MI · Lansing, MI · Traverse City, MI
Added 10 hours ago
Manager, Health Plan Provider Relations (Michigan)
Molina Talent Acquisition
Detroit, MI · Grand Rapids, MI · Flint, MI · Traverse City, MI · Lansing, MI
Added 11 hours ago
Pediatrics Care Manager LVN/LPN Hybrid in Orange County
Molina Talent Acquisition
Orlando, FL · Kissimmee, FL · Poinciana, FL · Davenport, FL
Added 11 hours ago
Pediatrics Care Manager LVN/LPN Hybrid in Brevard County
Molina Talent Acquisition
Palm Bay, FL
Added 13 hours ago
Transition of Care Coach (BH Licensed)
Molina Talent Acquisition
FL
Added 14 hours ago
Representative, Support Center II
Molina Talent Acquisition
United States
Added 15 hours ago
Program Manager, Medicare Stars & Quality Improvement (Remote)
Molina Talent Acquisition
United States
Added 15 hours ago
Health Plan Quality Program Mgmt & Performance Manager (Remote in TX)
Molina Talent Acquisition
TX
Added 16 hours ago
Program Manager (Remote)
Molina Talent Acquisition
United States
Added 16 hours ago
Manager, Leaves & Accommodations (Remote)
Molina Talent Acquisition
United States
Added 2 days ago
Pediatric Care Manager (LVN/LPN, RN, or Behavioral Health Licensed) – Hybrid in FL
Molina Talent Acquisition
FL
Added 2 days ago
Care Review Clinician - LPN
Molina Talent Acquisition
Detroit, MI
Added 2 days ago
Supervisor, Appeals & Grievances - Remote (PST)
Molina Talent Acquisition
United States
Added 2 days ago
Transition of Care Coach (RN)
Molina Talent Acquisition
San Antonio, TX
Added 2 days ago
Care Manager (RN)
Molina Talent Acquisition
Detroit, MI
Added 2 days ago
Pediatric Care Manager (RN - ECC) - Hybrid in St. Johns County, FL
Molina Talent Acquisition
Fernandina Beach, FL
Added 2 days ago
Pediatric Care Manager (RN - ECC) - Hybrid in Clay County, FL
Molina Talent Acquisition
Green Cove Springs, FL
Added 2 days ago
Specialist, Facilities
Molina Talent Acquisition
Bedford, TX
Added 2 days ago
Pediatric Care Manager (RN - ECC) - Hybrid in Hillsborough County, FL
Molina Talent Acquisition
Tampa, FL
Added 2 days ago
Pediatric Care Manager (RN) - Hybrid in Pinellas County, FL
Molina Talent Acquisition
Clearwater, FL · Largo, FL
Added 2 days ago
Representative, Health Plan Provider Relations - Boise, ID / Spokane, WA
Molina Talent Acquisition
Boise, ID · Coeur d'Alene, ID · Spokane, WA
Added 2 days ago
Program Manager (Marketplace Network Strategy & Payment Optimization) REMOTE
Molina Talent Acquisition
United States
Added 2 days ago
Senior Specialist, Health Plan Growth & Community Engagement (Not remote position)
Molina Talent Acquisition
Albuquerque, NM · Rio Rancho, NM · Los Ranchos de Albuquerque, NM

Molina Talent Acquisition

Care Manager, LTSS

Jefferson, WI, United States
Madison, WI, United States

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Job details

Education: Bachelor’s degree
Posting language: English
Posted: Oct 30, 2026

Original job description

***Remote with travel throughout Dane & Jefferson Counties, WI for member visits***

JOB DESCRIPTION

Job Summary

Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
Facilitates comprehensive waiver enrollment and disenrollment processes.
Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Performs ongoing monitoring of 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 (LTSS) and home and community resources to enhance continuity of care.
Assesses for medical necessity and authorizes all appropriate waiver services.
Evaluates covered benefits and advises appropriately regarding funding sources.
Facilitates interdisciplinary care team (ICT) 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 and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
Identifies critical incidents and develops prevention plans to assure member health and welfare.
Collaborates with licensed care managers/leadership as needed or required.
25-40% estimated local travel may be required (based upon state/contractual requirements).

Required Qualifications

At least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
Demonstrated knowledge of community resources.
Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
Ability to operate proactively and demonstrate detail-oriented work.
Ability to work independently, with minimal supervision and self-motivation.
Ability to demonstrate responsiveness in all forms of communication and remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
Problem-solving skills.
Strong verbal and written communication skills.
Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
In some states, must have at least one year of experience working directly with individuals with substance use disorders.

Preferred Qualifications

Experience working with populations that receive waiver services.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

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

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More about this job

Skills

Care planning
Collaboration
Leadership
Work independently
Communication skills
Time management
Prioritization
Adapt to change
Problem solving
Microsoft Office

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