Long Term Care Manager
Current• Completes clinical assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers from the assessment.• Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.• Conducts telephonic face-to-face or home visits as required.• Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.• Maintains ongoing member case load for regular outreach and management.• Promotes integration of services for members including behavioral health care and long term services and supports to enhance the continuity of care for Molina members.• May implement specific Molina wellness programs i.e. asthma and depression disease management.• 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.• Collaborates with RN case managers/supervisors as needed or required• Case managers in Behavioral Health and Social Science fields may provide consultation, resources and recommendations to peers as needed• Local travel of up to 40% may be required, depending on the complexity level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's Central Programs unit.
