Shire Jobs

JOB DESCRIPTION

Job Summary

Molina Healthcare Services (HCS) works with members, providers, and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

This position will be supporting our Transition of Care program. We are seeking a candidate with one of the following licensures: LPN, LSWAIC, LICSW, LMHC, or LMHCA. Excellent computer skills and attention to detail are very important. The ToC Coach will multitask between systems, talk with members/providers on the phone, enter accurate and timely contact notes. Previous experience with discharge planning, collaborating with Providers, transportation and additional resources. Must be able to work independently with a quick turn over to ensure our members receive the adequate resources for discharge. Experience with the adult behavioral health system in Washington State is highly preferred . Further details to be discussed during our interview process.

Remote position with field travel in Seattle, Tacoma or Everette WA

Work schedule M-F 8:30 AM to 5:00 PM PST.

KNOWLEDGE/SKILLS/ABILITIES

• Manage and process HCS requests for Supportive Supervision and Behavioral Health Personal Care benefits within required timelines.

• Create and update authorizations

• Utilize advanced clinical skills to review Care Assessments and available collateral information against criteria to support decision making.

• Comply with all policies, procedures, and documentation standards in appropriate systems, tracking mechanisms and databases.

• Collaborate with providers to determine acuity of mental health concerns, barriers, and progress; coordinate appropriate services.

• Refers appropriate cases to Medical Directors and presents them in a consistent and efficient manner.

• Requests additional information from members or providers in consistent and efficient manner.

JOB QUALIFICATIONS

Required Education

Any of the following:

• Completion of an accredited Licensed Vocational Nurse (LVN)

• Licensed Practical Nurse (LPN) Program

• Bachelor's or master’s degree in a social science, psychology, gerontology, public health or social work.

Required Experience

• 1-3 years in case management, disease management, managed care or medical or behavioral health settings.

• Knowledge of or experience using the Care Transitions Intervention or similar model; background in discharge planning and/or home health.

Required License, Certification, Association

• If required by applicable State, an LVN/LPN license in good standing.

• Otherwise, If licensed, license must be active, unrestricted and in good standing.

• Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

Preferred Experience

3-5 years in case management, disease management, managed care or medical or behavioral health settings.

Preferred License, Certification, Association

Any of the following:

• Transitions of Care Sub-Specialty Certification

• Licensed Clinical Social Worker (LCSW)

• Advanced Practice Social Worker (APSW)

• Certified Case Manager (CCM)

• Certified in Health Education and Promotion (CHEP)

• Licensed Professional Counselor (LPC/LPCC)

• Respiratory Therapist

• Licensed Marriage and Family Therapist (LMFT)

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $21.6 - $46.81 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.