Care Manager, LTSS (Remote in Idaho)

Job Summary For this position we are seeking a Care Manager who lives in Idaho. This position will not require LPN or LVN license. Care manager will support Idaho Medicaid and manage a case load of members enrolled in this program. The role requires experience working with Medicaid populations and/or a case management role, particularly with geriatric members. Excellent computer skills and diligence are essential to multitask between systems, conversation with members on the phone, and entering accurate contact notes. This is a fast‑paced position where productivity is important. The role includes field work conducting in‑person assessments with members in their homes. Travel (30%) – In‑field visits to members’ homes around the following areas of Idaho, with mileage reimbursed: Lewiston, Coeur d’Alene, Pocatello, Idaho Falls, Twin Falls, Post Falls. Schedule – Monday through Friday, 8:00 AM to 5:00 PM MST (no weekends or holidays). 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 other health care professionals to address member needs and goals. Performs ongoing monitoring of care plans 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. 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 working with persons with disabilities/chronic conditions long‑term services and supports (LTSS), and 1 year in care management, or experience in a medical and/or behavioral health setting, or an equivalent combination of relevant education and experience. Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required only if mandated by state contract, regulation, business operating model, or state board licensing mandates. If licensed, the license must be active and unrestricted in the 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—to work 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 proficiency, and ability to navigate online portals and databases. Preferred Qualifications Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in the state of practice. Experience working with populations that receive 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 USD $24 – $46.81 per hour (actual compensation may vary based on geographic location, work experience, education, and skill level). #J-18808-Ljbffr Molina Healthcare