Care Manager - RN/Licensed BH Professionals - Travel Required

Job Description

Opportunity for either an experienced Care Manager who is Bachelors or Masters trained in a social services field OR an Iowa licensed RN to join the LTSS team with our Iowa Health Plan. Responsibilities include conducting face-to-face and telephonic visits with our Medicaid members, completing assessments to determine the types of services we need to provide, and managing their care until they are discharged from your service. The ideal candidate will have experience as a Care Manager within a managed care organization (MCO) like Molina or have experience working with IHH assessments. Hours are Monday – Friday, 8 AM – 5 PM CST; 75% of your time will be spent in the field and the remainder you will work from your home office. Mileage is reimbursed as part of our benefit package. Solid experience with Microsoft Office Suite is necessary, especially with Outlook, Excel, and Teams as well as being confident in moving between different programs to complete the necessary forms and documentation. Due to contractual requirements with Iowa, we are unable to hire LPN/LVNs for this role. 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.