Company Detail

Molina Healthcare
Member Since,
Login to View contact details
Login

About Company

Job Openings

  • JOB DESCRIPTION Job Summary Provides support for care management/care... Read More
    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 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. * May provide 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 Social Worker (LCSW), Advanced Practice Social 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 related travel requirements, unless otherwise required by law. * Demonstrated knowledge of community resources. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work within 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 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, 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 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 Pay Range: $26.41 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. PDN-a1494d8d-87d2-4b30-8765-7750b4f03b63 Read Less
  • Care Manager, LTSS (North Cook County)  

    - Cook County
    JOB DESCRIPTION Job Summary Provides support for care management/care... Read More
    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 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 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. *Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation 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. * 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). Preferred Qualifications * Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. * 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 Pay Range: $25.2 - $49.15 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. PDN-a129c897-6bc6-40bd-bd44-1ee7a87932f5 Read Less
  • Molina Healthcare is hiring for Community Connectors inthe Phoenix Met... Read More
    Molina Healthcare is hiring for Community Connectors inthe Phoenix Metro area . This position serves as a member advocate and resource connector, using knowledge of the community and resources to engage and assist members in managing their healthcare needs. You will collaborate with and support the Healthcare Services team by providing non-clinical paraprofessional duties, including but not limited to, helping to complete annual paperwork, help direct and connect to resources, getting calls out to complete required screenings, etc. This important and critical role empowers members by helping them navigate and maximize their health plan benefits. This role will be a hybrid position where you will be mostly working remotely, however you must be available to see members in the community up to 50% of the time. An active Drivers License and reliable vehicle is required. Highly qualified candidates will have the following: Must reside in the Phoenix Metro area. Be highly customer centric with great communication skills, both written and verbal. Able and willing to meet with/work with members face to face in the community Experience in healthcare, home health, medical assisting, non-profits, social services, etc. Highly preferred is experience with Medicare, Medicaid, Managed Care, Must be familiar with MS Word and Excel. Above average computer skills needed as you will need to be able to navigate different computer systems. 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 includescheduling 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. Local travel may be required. Reliable transportation and valid driver's license required. REQUIRED EDUCATION: HS Diploma/GED PREFERRED EDUCATION: Associate degree in a health care related field (e.g., nutrition, counseling, social work). REQUIRED EXPERIENCE: Minimum 1 year experience working with underserved or special needs populations, with varied health, economic and educational circumstances. PREFERRED EXPERIENCE: Bilingual based on community needs. Familiarity with healthcare systems is a plus. Knowledge of community-specific culture. Experience with or knowledge of health care basics, community resources, social services, and/or health education. 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. 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 To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers competitive benefits and compensation packages. Key Words: Community Connector, Nonclinical Case Manager, Care Manager, Community Engagement, Public Health, Healthcare, Health Care, Managed Care, MCO, Medicaid, Medicare, HEDIS, CAPHS, equity community health advisor, family advocate, advocacy, health educator, liaison, promoter, outreach worker, peer counselor, patient navigator, health interpreter, public health aide,community lead, community advocate, nonprofit, non-profit, social worker, case worker, housing counselor, human service worker,Navigator, Assistor, Connecter, Promotora, Marketing, managed care, MCO, member, market, screening, education, educating, resource #PJCorp Pay Range: $18.35 - $31.97 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. PDN-a129c899-0a48-48b4-9789-bb1107309e96 Read Less
  • Care Manager (BH Licensed) - Reentry Program  

    - McCracken County
    Job Summary Provides support for care management/care coordination act... Read More
    Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. 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 behavioral health assessments of members per regulated timelines and determines who may qualify for care coordination/case management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments *Conduct in-person visits with incarcerated members to complete health assessments and develop person-centered care plans that support a safe and successful transition back into the community *Collaborate closely with Department of Corrections and Reentry staff, as well as Parole and Probation partners, to coordinate services, remove barriers, and ensure a smooth continuity of care during the reentry process * Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate healthcare professionals and member support network to address member needs and goals * Conducts telephonic, face-to-face or home visits as required * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly * Maintains ongoing member caseload for regular outreach and management * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care * Facilitates interdisciplinary care team meetings 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, provides care coordination and assistance to member to address concerns * May provide 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 health care experience, preferably in behavioral health, or equivalent combination of relevant education and experience * Licensed behavioral health clinician to include: Licensed Clinical Social Worker (LCSW), Advanced Practice Social 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. If licensed, license must be active and unrestricted in state of practice * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law * Experience with working with persons with severe and persistent mental health concerns and serious emotional disturbances, to include substance use disorder and foster care * Knowledge and experience related to whole person care principles, chronic health conditions, and discharge planning coordination * Data entry skills and previous experience utilizing a clinical platform * Excellent verbal and written communication skills * Microsoft Office suite/applicable software program(s) proficiency Preferred Qualifications * Certified Case Manager (CCM) * Experience in behavioral health care management * Field-based care management or home health experience 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 Pay Range: $25.08 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. PDN-a13280e9-1058-4a9f-80d6-9c1f93846052 Read Less
  • Job Summary Provides support for care management/care coordination act... Read More
    Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. 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 behavioral health assessments of members per regulated timelines and determines who may qualify for care coordination/case management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments *Conduct in-person visits with incarcerated members to complete health assessments and develop person-centered care plans that support a safe and successful transition back into the community *Collaborate closely with Department of Corrections and Reentry staff, as well as Parole and Probation partners, to coordinate services, remove barriers, and ensure a smooth continuity of care during the reentry process * Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate healthcare professionals and member support network to address member needs and goals * Conducts telephonic, face-to-face or home visits as required * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly * Maintains ongoing member caseload for regular outreach and management * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care * Facilitates interdisciplinary care team meetings 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, provides care coordination and assistance to member to address concerns * May provide 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 health care experience, preferably in behavioral health, or equivalent combination of relevant education and experience * Licensed behavioral health clinician to include: Licensed Clinical Social Worker (LCSW), Advanced Practice Social 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. If licensed, license must be active and unrestricted in state of practice * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law * Experience with working with persons with severe and persistent mental health concerns and serious emotional disturbances, to include substance use disorder and foster care * Knowledge and experience related to whole person care principles, chronic health conditions, and discharge planning coordination * Data entry skills and previous experience utilizing a clinical platform * Excellent verbal and written communication skills * Microsoft Office suite/applicable software program(s) proficiency Preferred Qualifications * Certified Case Manager (CCM) * Experience in behavioral health care management * Field-based care management or home health experience 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 Pay Range: $25.08 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. PDN-a13280e9-26eb-485c-8d64-bedd5eeb0051 Read Less
  • JOB DESCRIPTION Job SummaryProvides non-clinical administrative suppor... Read More
    JOB DESCRIPTION Job SummaryProvides non-clinical administrative support to utilization management team and contributes to interdisciplinary efforts supporting provision of integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Provides telephone, clerical and data entry support for the care review team. * Provides computer entries of authorization request/provider inquiries, such as eligibility and benefits verification, provider contracting status, diagnosis and treatment requests, coordination of benefits status determination, hospital census information regarding admissions and discharges and billing codes. * Responds to requests for authorization of services submitted via phone, fax and mail according to operational timeframes. * Contacts physician offices according to department guidelines to request missing information from authorization requests or for additional information as requested medical directors. Required Qualifications*At least 1 year of experience in an administrative support role, preferably within a health care environment supporting correspondence or clinical communications, or equivalent combination of relevant education and experience. * Previous experience as a Correspondence Processor at Molina. * Strong attention to detail, and ability to work within regulatory and internal requirements for letter generation. * Strong organizational and time-management skills, and ability to manage multiple letter queues and deadlines. * Excellent verbal and written communication skills, and ability to ensure clarity and precision in all correspondence. * Willingness to learn and adapt to new programs, software systems, and lines of business. * Ability to research, obtain feedback, and integrate necessary adjustments into letters to meet quality standards. * Ability to manage multiple tasks simultaneously, and ensure quality and compliance in all produced correspondence. * Ability to maintain confidentiality and ensure compliance with all relevant guidelines, regulations, and policies in processing of clinical correspondence. * Ability to work effectively in a fast-paced, high-volume environment, maintain accuracy and meet deadlines. * Ability to collaborate effectively with team members and internal departments. * Basic Microsoft Office suite/applicable software program(s) proficiency. Shifts Available Dayshift: 6:00 AM - 2:30 PM Schedule: Tuesday to Saturday 5 days / 8-hour shifts Preferred Qualifications * Previous experience in a health care correspondence or clinical communications role, with an understanding of regulatory and accreditation rules related to clinical determinations. 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 #PJHS #LI-AC1 Pay Range: $20.25 - $30.39 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. PDN-a1449dfd-f1f6-4bff-8918-cc2173c87576 Read Less
  • JOB DESCRIPTION Job Summary Provides support for care management/care... Read More
    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 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 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. *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 - 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. * 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). Preferred Qualifications * Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. * 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 #PJHS #HTF Pay Range: $24 - $46.81 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. PDN-a1419719-1fd3-4d60-a952-e04270518096 Read Less
  • Field Care Manager, LTSS - Local Travel Required (WATERLOO)  

    - Black Hawk County
    JOB DESCRIPTION Job Summary Provides support for care management/care... Read More
    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 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 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. *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 - 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. * 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). Preferred Qualifications * Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. * Experience working with populations that receive waiver services. #PJHS #LI-AC1 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 Pay Range: $22.8 - $46.81 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. PDN-a148a31e-4ccf-4d1d-9085-e8634f7dfe92 Read Less
  • **JOB DESCRIPTION** **Job Summary** Responsible for increasing members... Read More
    **JOB DESCRIPTION** **Job Summary** Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within approved market areas to achieve stated revenue, profitability, and retention goals, while following ethical sales practices and adhering to established policies and procedures. **KNOWLEDGE/SKILLS/ABILITIES** + Develop sales strategies to procure sufficient number of referrals and other self-generated leads to meet sales targets through active participation in community events and targeted community outreach to group associations, community centers, senior centers, senior residences and other potential marketing sites. + Generate leads from referrals and local-tactical research and prospecting. + Work assigned (company generated) leads in a timely manner. + Schedule individual meetings and group presentations from assigned/self-generated leads. + Achieve/Exceed monthly sales targets. + Conduct presentations with potential customers. Customize sales presentations and develop sales skills to increase effectiveness in establishing rapport, assessing individual needs, and communicating product features and differences. + Enroll eligible individuals in Molina Medicare products accurately and thoroughly complete and submit required enrollment documentation, consistent with Medicare requirements and enrollment guidelines. Assist the prospect in completion of the enrollment application. Forward completed applications to appropriate administrative contact within 48 hours of sale. + Ensure Medicare beneficiaries accurately understand the product choices available to them, the enrollment process (eligibility requirements, Medicare review/approval of their enrollment application, timing of ID card receipt, etc.) and the service contacts and process. + Track all marketing and sales activities, as well as update and maintain sales prospects daily, weekly and monthly results in SalesForce.com. + Work closely with network providers to identify and educate potential members; participate in provider promotional activities. **JOB QUALIFICATIONS** **Required Education** High School diploma/GED **Required Experience** 2+ years Medicare, Medicaid, managed care or other health/insurance related sales experience **Required License, Certification, Association** Active, unrestricted Life Read Less
  • Care Manager (BH Licensed)  

    - Pottawattamie County
    This is a remote field-based role requiring travel within Iowa. Job Su... Read More
    This is a remote field-based role requiring travel within Iowa. Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. 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 behavioral health assessments of members per regulated timelines and determines who may qualify for care coordination/case management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. * Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate healthcare professionals and member support network to address member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member caseload for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. * Facilitates interdisciplinary care team meetings 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, provides care coordination and assistance to member to address concerns. * May provide 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 health care experience, preferably in behavioral health, or equivalent combination of relevant education and experience. * Licensed behavioral health clinician to include: Licensed Clinical Social Worker (LCSW), Advanced Practice Social 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. If licensed, license must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Experience with working with persons with severe and persistent mental health concerns and serious emotional disturbances, to include substance use disorder and foster care. * Knowledge and experience related to whole person care principles, chronic health conditions, and discharge planning coordination. * Data entry skills and previous experience utilizing a clinical platform. * Excellent verbal and written communication skills. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Certified Case Manager (CCM). * Experience in behavioral health care management. * Field-based care management or home health experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. #PJHS #LI-AC1 Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $25.08 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. PDN-a1388b44-0a97-45ee-93d4-9ed04f11045b Read Less

Company Detail

  • Is Email Verified
    No
  • Total Employees
  • Established In
  • Current jobs

Google Map

For Jobseekers
For Employers
Contact Us
Astrid-Lindgren-Weg 12 38229 Salzgitter Germany