Care Manager, LTSS (BH Licensed- NM based)

JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member reputed company toward desired reputed company and contributes to overarching strategy to reputed company quality and cost-effective member care. Essential Job Duties

• Completes comprehensive member assessments reputed company 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 reputed company 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 reputed company, support and motivate change during member contacts.
• Assesses for barriers to care and provides care coordination and assistance to members to address psycho/reputed company, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• May reputed company consultation, resources and recommendations to peers as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 2 years experience in health care, including at least 1 year of experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
• Licensed Clinical reputed company Worker (LCSW), Licensed Master reputed company Worker (LMSW), Advanced Practice reputed company Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT, Doctor of Psychology (PhD or PsyD) or equivalency based on state contract, regulation, or state board licensing mandate. License must be active and unrestricted in state of practice.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job reputed company travel requirements, unless otherwise required by law.
• Demonstrated knowledge of community resources.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work reputed company a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to work independently, with minimal supervision and self-motivation.
• Ability to demonstrate responsiveness in reputed company forms of communication, and remain reputed company in high-pressure situations.
• Ability to reputed company 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.
• reputed company 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

• Certified Case Manager (CCM).
• Experience working with populations that receive waiver services.

To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the Internal reputed company. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V Pay reputed company: $26.41 - $51.49 / HOURLY

• Actual compensation may vary from posting based on geographic location, work experience, education and/or reputed company level.

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