Care Manager, LTSS
Hybrid · Eau Claire, Wisconsin, United States
Job Summary
Provides care management/care coordination for LTSS, including comprehensive member assessments (in-person home visits as required), facilitating waiver enrollment and disenrollment, developing and implementing care plans with members, caregivers, physicians and/ or other health care professionals to address needs and goals. Performs ongoing monitoring of care plans, promotes integration of services (behavioral health and LTSS) to enhance continuity of care, assesses medical necessity and authorizes appropriate waiver services, evaluates benefits and funding sources, facilitates ICT meetings for approval/denial of services, uses motivational interviewing and Molina clinical guideposts to educate and motivate change, identifies barriers to care and provides coordination to address psycho/social, financial, and medical obstacles, identifies critical incidents and develops prevention plans, collaborates with licensed care managers/leadership as needed, and expects 25-40% local travel.
Required Qualifications
- At least 2 years 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 equivalent combination of relevant education and experience.
- Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). 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.
- 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.
- Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
- Excellent problem-solving, and critical-thinking 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, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
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