Company Detail

Job Description

*Remote and must live in Nebraska*

Job Description

Job Summary

Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service.

Job Duties

This role serves as the primary point of contact between Molina Health plan and the Plan's highest priority, high volume and strategic non-complex Provider Community that services Molina members, including but not limited to Fee-For-Service and Pay for Performance Providers. It is an external-facing, field-based position requiring an in-depth knowledge of provider relations and contracting subject matter expertise to successfully engage high priority providers, including senior leaders and physicians, to ensure provider satisfaction, education on key Molina initiatives, and improved coordination and partnership.

- Under general supervision, works directly with the Plan's external providers to educate, advocate and engage as valuable partners, ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service. Effectiveness in driving timely issue resolution, EMR connectivity, Provider Portal Adoption.

- Resolves complex provider issues that may cross departmental lines and involve Senior Leadership.

- Serves as a subject matter expert for other departments.

- Conducts regular provider site visits within assigned region/service area. Determines own daily or weekly schedule, as needed to meet or exceed the Plan's monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with the provider and staff to determine, for example, non-compliance with Molina policies/procedures or CMS guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.

- Provides on-the-spot training and education as needed, which may include counseling providers diplomatically, while retaining a positive working relationship.

- Independently troubleshoots problems as they arise, making an assessment when escalation to a Senior Representative, Supervisor, or another Molina department is needed. Takes initiative in preventing and resolving issues between the provider and the Plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.

- Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians. For example, such meetings would occur to discuss and resolve issues related to utilization management, pharmacy, quality of care, and correct coding.

- Independently delivers training and presentations to assigned providers and their staff, answering questions that come up on behalf of the Health plan. May also deliver training and presentations to larger groups, such as leaders and management of provider offices (including large multispecialty groups or health systems, executive level decision makers, Association meetings, and JOC's).

- Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives. Examples of such initiatives include: administrative cost effectiveness, member satisfaction - CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, Provider Website, etc.).

- Trains other Provider Relations Representatives as appropriate.

- Role requires 80%+ same-day or overnight travel. (Extent of overnight travel will depend on the specific Health Plan and its service area.)

Job Qualifications

REQUIRED EDUCATION :

Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting.

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :

- 3 - 5 years customer service, provider service, or claims experience in a managed care setting.

- 3+ years experience in managed healthcare administration and/or Provider Services.

- Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation and various forms of risk, ASO, etc.

PREFERRED EXPERIENCE :

- 5+ years experience in managed healthcare administration and/or Provider Services.

- 3+ years experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e. physician, groups and hospitals).

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: $49,930 - $97,363 a year*

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

Job Detail

• Company:
  Molina Healthcare

Job Description

*Remote and must live in Nebraska or a boarding state*

JOB DESCRIPTION

Job Summary

Negotiates agreements with highly visible providers who are strategic to the success of the Plan, including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers.

KNOWLEDGE/SKILLS/ABILITIES

• In conjunction with Director/Manager Provider Contracts, negotiates high priority physician group and facility contracts using Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines.

• Develops and maintains provider contracts in APTTUS contract management software.

• Targets and recruits additional providers to reduce member access grievances.

• Engages targeted contracted providers in renegotiation of rates and/or language. Assists with cost control strategies that positively impact the Medical Care Ratio (MCR) within each region.

• Maintains contractual relationships with significant/highly visible providers.

• Advises Network Provider Contract Coordinators and Specialists on negotiation of individual provider and routine ancillary contracts.

• Evaluates provider network and implement strategic plans with the goal of meeting Molina's network adequacy standards.

• Assesses contract language for compliance with Corporate standards and regulatory requirements and review revised language with assigned MHI attorney.

• Participates in fee schedule determinations including development of new reimbursement models. Seeks input on new reimbursement models from Corporate Network Management and legal.

• Educates internal customers on provider contracts.

• Participates on the management team and other committees addressing the strategic goals of the department and organization.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree in a healthcare related field or an equivalent combination of education and experience.

Required Experience

5-7 years

Preferred Education

Graduate degree

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: $66,456.22 - $129,589.63 a year*

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

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you!

We're currently looking for someone with a social services or human services background to join our team. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS Program and the TMG IRIS Consultant Agency. While your office will be home-based, you will have regularly scheduled visits with IRIS participants in their home and community.

As an IRIS Consultant (IC), you will build relationships with the people you partner with and help them navigate and get the most out of the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. You can learn more about the IRIS program on the Wisconsin Department of Health Services website here (https://dhs.wisconsin.gov/iris/index.htm) . Together, you will identify the long-term care goals of the people enrolled in IRIS, and find creative ways to achieve those goals.

ICs play an important role in helping people of various backgrounds and abilities live the lives that they choose. In fact, people constantly tell us how supportive our ICs are and what a positive impact our ICs have had on their lives! Successful candidates for this position will be compassionate, genuine, resourceful partners with an eye for high quality work, and who are excited to work side-by side with people enrolled in IRIS.

As an IC, you will connect people to the resources available in their community. You will also help them develop customized IRIS plans for achieving their goals related to employment, housing, health, safety, community membership, transportation, and lasting relationships. While you will have a routine for the work that you do, no two days are alike!

TMG wants to find the best possible candidates, so we created this Realistic Job Preview to provide you with an inside look at the position and our organization. Find out more about the IRIS Consultant position by clicking on the link (https://www.youtube.com/watch?v=2vCojx1dK3I) and then reviewing the job posting below.

TMG is committed to maintaining a diverse and inclusive workforce and prioritizes helping staff have a good work/life balance. Even though the position is remote, you'll have lots of support from your TMG team and coworkers across the organization. If this sounds like the job for you, apply today!

KNOWLEDGE/SKILLS/ABILITIES

• Required to meet in person with the IRIS participant a minimum of four times per year, with one required annual visit in the home of the participant. Because IRIS is a self-directed program, it is important for ICs to be available upon the request of the participant.

• Responsible for providing program orientation to new participants. During this time, participants will learn their rights and responsibilities as someone enrolled in the IRIS program, including verifying legal documents, completing employee paperwork and the responsible use of public dollars.

• Explore a broad view of the participant's life, including goals, important relationships, connections with the local community, interest in employment, awareness of the Self-Directed Personal Care option, and back-up support plans.

• Assist participants in identifying personal outcomes and ensure those outcomes are being met on an ongoing basis, all while staying within the participant's IRIS budget and within the requirements of the IRIS program determined by the Department of Health Services (DHS).

• Responsible for documenting all orientation and planning activities within the IRIS data system (WISITs) within 48 business hours of the visit with the participant.

• Research community resources and natural supports that will fit the individual outcomes for each participant and share that information with them as it becomes available.

• Responsible for documenting progress and changes as needed within the plan and the data system anytime a modification is requested by a participant.

• Budget Amendment or One-Time Expense paperwork may be required depending upon factors associated with the participant and their individual IRIS budget.

• Educate participants on how to read and interpret their monthly budget reports to ensure that participants operate within their budget. Being a liaison between the Fiscal Employer Agency and the IRIS Consultant Agency is also a large part of the position, which includes assisting participants with provider billing, seeking support brokers, tracking receipts, ensuring their workers are paid and mitigating areas of potential risk or conflicts of interest.

• Responsible to develop engaged and trusting relationships with participants and communicate program changes and compliance effectively.

• Responsible to maintain confidentiality and HIPPA compliance.

• Work collaboratively with other IRIS Consultant Agency staff in order to ensure a successful implementation of participants' plans.

• Attend in-person monthly team meetings with other ICs and their supervisor. In addition, weekly IC and IRIS Consultant Supervisor phone check-ins may occur, along with other duties as assigned.

JOB QUALIFICATIONS

Required Education

Bachelor's degree in a social work, psychology, human services, counseling, nursing, special education, or a closely related field (or four years of commensurate experience if no degree).

Required Experience

• 1+ year of direct experience related to the delivery of social services to the target groups (individuals with intellectual or physical disabilities and older adults).

• Ability to work independently, with minimal supervision and be self-motivated.

• Knowledge of Long-Term Care programs and familiarity with principles of self-determination.

• Excellent problem-solving skills, critical thinking skills and strong basic math skills.

• Excellent time management and prioritization skills to focus on multiple projects simultaneously and adapt to change.

• Ability to develop and maintain professional relationships and work through situations without taking it personally.

• Comfortable working within a variety of settings and adjust style as needed; to work with a diverse population, various personalities, and personal situations.

• Resourceful and have knowledge of community resources while being proactive and detail oriented.

• Ability to use a variety of technology including but not limited to, Outlook, Skype, Teams, PowerPoint, Excel, Word, online portals and databases.

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.

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: $18.04/hr - $35.17/hr*

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

Pay Range: $16.23 - $35.17 / HOURLY

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

Job Detail

• Company:
  Molina Healthcare

Job Description

*Remote and must live in Michigan*

JOB DESCRIPTION

Job Summary

Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs specific to the Provider Network; ensures maintenance of Provider Quality Improvement programs in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities.

KNOWLEDGE/SKILLS/ABILITIES

The Specialist, Provider Engagement contributes to one or more of these quality improvements functions:

• Implements key quality strategies, which may include initiation and management of provider, member and/or community interventions (e.g., removing barriers to care); and other federal and state required quality activities.

• Monitors and ensures that key quality activities are completed on time and accurately to present results to key departmental management and other Molina departments as needed.

• Writes narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions.

• Creates, manages, and/or compiles the required documentation to maintain critical quality improvement functions.

• Leads quality improvement activities, meetings, and discussions with and between other departments within the organization or with and between key provider network partners.

• Evaluates project/program activities and results to identify opportunities for improvement.

• Surfaces to Manager and Director any gaps in processes that may require remediation.

• Other tasks, duties, projects, and programs as assigned.

• This position may require same day out of office travel approximately 0 - 80% of the time, depending upon location.

• This position may require multiple day out of town overnight travel approximately on occasion, depending upon location.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree or equivalent combination of education and work experience.

Required Experience

• Min. 3 years' experience in healthcare with 1 year experience in health plan quality improvement, managed care or equivalent experience.

• Demonstrated solid business writing experience.

• Operational knowledge and experience with Excel and Visio (flow chart equivalent).

Preferred Education

Preferred field: Clinical Quality, Public Health or Healthcare.

Preferred Experience

1 year of experience in Medicare and in Medicaid.

Preferred License, Certification, Association

• Certified Professional in Health Quality (CPHQ)

• Nursing License (RN may be preferred for specific roles)

• Certified HEDIS Compliance Auditor (CHCA)

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: $45,390 - $88,511 a year*

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

Pay Range: $40,851.44 - $88,511.46 / ANNUAL

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

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Opportunity for a TX licensed RN to work as a Case Manager; part of the duties of the position include conducting face-to-face visits with our members in the Lake Jackson, TX service area. Schedule is Monday - Friday, 8 AM - 5 PM CST and mileage is reimbursed as part of our benefit package.

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.

KNOWLEDGE/SKILLS/ABILITIES

• Completes face-to-face comprehensive assessments of members per regulated timelines.

• Facilitates comprehensive waiver enrollment and disenrollment processes.

• Develops and implements a case management plan, including a waiver service 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.

• Performs ongoing monitoring of the 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, home and community to enhance the continuity of care for Molina members.

• Assesses for medical necessity and authorize all appropriate waiver services.

• Evaluates covered benefits and advise appropriately regarding funding source.

• Conducts face-to-face or home visits as required.

• Facilitates interdisciplinary care team 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, provides care coordination and assistance to member to address psycho/social, financial, and medical obstacles concerns.

• Identifies critical incidents and develops prevention plans to assure member's health and welfare.

• Provides consultation, recommendations and education as appropriate to non-RN case managers

• Works cases with members who have complex medical conditions and medication regimens

• Conducts medication reconciliation when needed.

• 50-75% travel required.

JOB QUALIFICATIONS

Required Education

Graduate from an Accredited School of Nursing

Required Experience

• At least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports.

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

• Required License, Certification, Association

• Active, unrestricted State Registered Nursing license (RN) in good standing

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

State Specific Requirements

Virginia: Must have at least one year of experience working directly with individuals with Substance Use Disorders

Preferred Education

Bachelor's Degree in Nursing

Preferred Experience

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

• 1 year experience working with population who receive waiver services.

Preferred License, Certification, Association

Active and unrestricted Certified Case Manager (CCM)

Pay Range: $26.41 - $51.49 per hour*

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

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.

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

TMG is on the lookout for our next great Eligibility Screener! If you love doing meaningful work that helps others live their best lives, we want to hear from you!

We're currently in search for someone with a background in human services, social work, healthcare or case management to join our team. This is a remote position, where you will partner with people in your community who use the TMG IRIS Consultant Agency. While this role is home-based, you will spend most days visiting IRIS participants in their homes. While you'll have a routine for the work that you do, no two days are alike!

As an Eligibility Screener, you would be responsible for completing the Adult Long-Term Care Functional Screens (LTC-FS) for participants of the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. The job includes completing annual rescreens and any change-in-condition screens using the Adult LTC-FS tool to ensure program eligibility. Successful candidates will be approachable, compassionate and respectful of people of all different backgrounds and abilities, and be able to see and articulate the strengths that people inherently have.

TMG is committed to maintaining a diverse and inclusive workforce, and prioritizes helping staff have a good work/life balance. Even though the position is remote, you'll have lots of support from your TMG team and coworkers across the organization. If this sounds like the job for you, apply today!

Job Duties

• Meets with IRIS participants face to face to complete the screening process.

• Completes the Adult Long Term Care Functional Screen (LTC-FS) for people in IRIS according to the Wisconsin Adult LTC-FS Instructions.

• Completes contacts to verify screen results with IRIS Consultants, Medicaid Personal Care agencies, and verifies diagnosis information with physicians and the Social Security Administration, when needed.

• Meets the highest standards of documentation and program regulations, while ensuring timely completion of screens.

• Maintains screening skills by participating in weekly team meetings, monthly All Screener Meetings, trainings and testing.

• Other duties as assigned by management.

Job Qualifications

REQUIRED EDUCATION :

Bachelor's Degree in a health or human services or related field. (e.g., social work, psychology) or graduate from an Accredited School of Nursing.

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :

• 1+ years of experience working with one of the target groups such as adults with physical or intellectual disabilities or older adults.

• Strong written and verbal communication skills; strong attention to detail.

• Demonstrated computer and software skills required; proficiency with Microsoft Office Suite and other software.

• Strong customer service skills.

• Good organizational and time management skills.

• The ability to work cooperatively as part of a team or autonomously

• Ability to remain flexible in the work environment and willing and able to adapt to changing organizational needs.

• Travel Requirements 5%

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION :

• Must pass the Wisconsin Adult Long-term Care Functional Screen certification modules (80% or higher on each module) within first week of hire and maintain certification as a screener.

• If a graduate from an Accredited School of Nursing, must have an active, unrestricted Wisconsin Registered Nursing (RN) license in good standing

• Must possess a valid driver's license, maintain adequate auto insurance for job-related travel and ability to travel throughout Wisconsin or other

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION :

Currently or formerly certified in the Long-Term Care Functional Screen.

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: $18.04/hr - $35.17/hr*

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

#PJHS

#LI-BEMORE

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Builds company specific systems and technology expertise across multiple infrastructure and development disciplines

Knowledge/Skills/Abilities

- Responsible for task management and adherence to process controls.

- Responsible for troubleshooting and incident resolution for support functions.

- Contributes to on-call rotation schedules and off-hour support activities.

- Contributes to organize, manage and lead cross-team project tasks and deliverables.

- Contributes to the Infrastructure Solution Architect project design function.

- Contributes to solution architecture delivery within project management methodologies and timelines.

- Contributes to root cause analysis and problem solving.

- Contributes to tactical build and configuration activities.

- Provides cross-organization teamwork, collaboration, communication and leadership.

- Provides constructive feedback on people, process and technology for continuous improvement..

Job Qualifications

Required Education

- Bachelor's Degree.

Required Experience

1-4 years of IT technical experience with IT enterprise infrastructure.

Industry certifications preferred.

Experience in design and management of cloud-based network infrastructure.

Experience in network administration and support in a Microsoft server environment.

Experience with configuring and maintaining network switches, VLANS, routers, and firewalls.

Experience working in a large very complex organization.

Preferred Experience

Experience working within a health care organization.

Experience in a help desk, technology-oriented field, or on a technology support team.

Knowledge of Software-Defined Network (SDWAN), Local Area Networks (LANs), Wireless Local Area Networks (WLANS), and Wide Area Networks (WANs).

Experience utilizing Cisco security suite/tools.

Experience with a Virtual Private Network (VPN), with network monitoring tools or other SNMP monitoring software, and with system backup.

Enterprise (global) AD administration in a Multi-Domain Architecture.

Certifications below or comparable in network, network security and engineering

CISSP (Certified Information System Security Professional)

CISM (Certified Information Security Manager)

MCSE (Microsoft Certified Solutions Expert)

CCNA (Cisco Certified Network Associate) or CCNP (Cisco Certified Network Professional)

Pay Range: $60,415 - $117,809 a year*

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

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.

#PJCorp

#LI-BEMORE

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you!

We're currently looking for someone with a social services or human services background to join our team. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS Program and the TMG IRIS Consultant Agency. While your office will be home-based, you will have regularly scheduled visits with IRIS participants in their home and community.

As an IRIS Consultant (IC), you will build relationships with the people you partner with and help them navigate and get the most out of the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. You can learn more about the IRIS program on the Wisconsin Department of Health Services website here (https://dhs.wisconsin.gov/iris/index.htm) . Together, you will identify the long-term care goals of the people enrolled in IRIS, and find creative ways to achieve those goals.

ICs play an important role in helping people of various backgrounds and abilities live the lives that they choose. In fact, people constantly tell us how supportive our ICs are and what a positive impact our ICs have had on their lives! Successful candidates for this position will be compassionate, genuine, resourceful partners with an eye for high quality work, and who are excited to work side-by side with people enrolled in IRIS.

As an IC, you will connect people to the resources available in their community. You will also help them develop customized IRIS plans for achieving their goals related to employment, housing, health, safety, community membership, transportation, and lasting relationships. While you will have a routine for the work that you do, no two days are alike!

TMG wants to find the best possible candidates, so we created this Realistic Job Preview to provide you with an inside look at the position and our organization. Find out more about the IRIS Consultant position by clicking on the link (https://www.youtube.com/watch?v=2vCojx1dK3I) and then reviewing the job posting below.

TMG is committed to maintaining a diverse and inclusive workforce and prioritizes helping staff have a good work/life balance. Even though the position is remote, you'll have lots of support from your TMG team and coworkers across the organization. If this sounds like the job for you, apply today!

KNOWLEDGE/SKILLS/ABILITIES

• Required to meet in person with the IRIS participant a minimum of four times per year, with one required annual visit in the home of the participant. Because IRIS is a self-directed program, it is important for ICs to be available upon the request of the participant.

• Responsible for providing program orientation to new participants. During this time, participants will learn their rights and responsibilities as someone enrolled in the IRIS program, including verifying legal documents, completing employee paperwork and the responsible use of public dollars.

• Explore a broad view of the participant's life, including goals, important relationships, connections with the local community, interest in employment, awareness of the Self-Directed Personal Care option, and back-up support plans.

• Assist participants in identifying personal outcomes and ensure those outcomes are being met on an ongoing basis, all while staying within the participant's IRIS budget and within the requirements of the IRIS program determined by the Department of Health Services (DHS).

• Responsible for documenting all orientation and planning activities within the IRIS data system (WISITs) within 48 business hours of the visit with the participant.

• Research community resources and natural supports that will fit the individual outcomes for each participant and share that information with them as it becomes available.

• Responsible for documenting progress and changes as needed within the plan and the data system anytime a modification is requested by a participant.

• Budget Amendment or One-Time Expense paperwork may be required depending upon factors associated with the participant and their individual IRIS budget.

• Educate participants on how to read and interpret their monthly budget reports to ensure that participants operate within their budget. Being a liaison between the Fiscal Employer Agency and the IRIS Consultant Agency is also a large part of the position, which includes assisting participants with provider billing, seeking support brokers, tracking receipts, ensuring their workers are paid and mitigating areas of potential risk or conflicts of interest.

• Responsible to develop engaged and trusting relationships with participants and communicate program changes and compliance effectively.

• Responsible to maintain confidentiality and HIPPA compliance.

• Work collaboratively with other IRIS Consultant Agency staff in order to ensure a successful implementation of participants' plans.

• Attend in-person monthly team meetings with other ICs and their supervisor. In addition, weekly IC and IRIS Consultant Supervisor phone check-ins may occur, along with other duties as assigned.

JOB QUALIFICATIONS

Required Education

Bachelor's degree in a social work, psychology, human services, counseling, nursing, special education, or a closely related field (or four years of commensurate experience if no degree).

Required Experience

• 1+ year of direct experience related to the delivery of social services to the target groups (individuals with intellectual or physical disabilities and older adults).

• Ability to work independently, with minimal supervision and be self-motivated.

• Knowledge of Long-Term Care programs and familiarity with principles of self-determination.

• Excellent problem-solving skills, critical thinking skills and strong basic math skills.

• Excellent time management and prioritization skills to focus on multiple projects simultaneously and adapt to change.

• Ability to develop and maintain professional relationships and work through situations without taking it personally.

• Comfortable working within a variety of settings and adjust style as needed; to work with a diverse population, various personalities, and personal situations.

• Resourceful and have knowledge of community resources while being proactive and detail oriented.

• Ability to use a variety of technology including but not limited to, Outlook, Skype, Teams, PowerPoint, Excel, Word, online portals and databases.

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.

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: $18.04/hr - $35.17/hr*

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

Pay Range: $16.23 - $35.17 / HOURLY

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

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Builds company specific systems and technology expertise across multiple infrastructure and development disciplines

Knowledge/Skills/Abilities

- Responsible for task management and adherence to process controls.

- Responsible for troubleshooting and incident resolution for support functions.

- Contributes to on-call rotation schedules and off-hour support activities.

- Contributes to organize, manage and lead cross-team project tasks and deliverables.

- Contributes to the Infrastructure Solution Architect project design function.

- Contributes to solution architecture delivery within project management methodologies and timelines.

- Contributes to root cause analysis and problem solving.

- Contributes to tactical build and configuration activities.

- Provides cross-organization teamwork, collaboration, communication and leadership.

- Provides constructive feedback on people, process and technology for continuous improvement..

Job Qualifications

Required Education

- Bachelor's Degree.

Required Experience

1-4 years of IT technical experience with IT enterprise infrastructure.

Industry certifications preferred.

Experience in design and management of cloud-based network infrastructure.

Experience in network administration and support in a Microsoft server environment.

Experience with configuring and maintaining network switches, VLANS, routers, and firewalls.

Experience working in a large very complex organization.

Preferred Experience

Experience working within a health care organization.

Experience in a help desk, technology-oriented field, or on a technology support team.

Knowledge of Software-Defined Network (SDWAN), Local Area Networks (LANs), Wireless Local Area Networks (WLANS), and Wide Area Networks (WANs).

Experience utilizing Cisco security suite/tools.

Experience with a Virtual Private Network (VPN), with network monitoring tools or other SNMP monitoring software, and with system backup.

Enterprise (global) AD administration in a Multi-Domain Architecture.

Certifications below or comparable in network, network security and engineering

CISSP (Certified Information System Security Professional)

CISM (Certified Information Security Manager)

MCSE (Microsoft Certified Solutions Expert)

CCNA (Cisco Certified Network Associate) or CCNP (Cisco Certified Network Professional)

Pay Range: $60,415 - $117,809 a year*

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

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.

#PJCorp

#LI-BEMORE

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you'll want to keep reading about this rewarding work opportunity!

We are currently looking for a Registered Nurse licensed in Wisconsin to become our next IRIS Self-Directed Personal Care (SDPC) RN. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. People in the IRIS program who need personal care services have the choice to enroll in the IRIS Self-Directed Personal Care (IRIS SPDC) option. You can learn more about IRIS SDPC on the Wisconsin Department of Health Services website here (https://dhs.wisconsin.gov/iris/sdpc.htm) , and learn about the IRIS program here (https://dhs.wisconsin.gov/iris/index.htm) . While this role is home-based, you will have regularly scheduled visits with people in their homes and communities.

As an IRIS SDPC RN, you'll provide oversight and guidance to the people enrolled in the IRIS SDPC option. You'll also build relationships with the people you partner with and ensure that they're getting the most out of the IRIS Self-Directed Personal Care option through assessment, oversight, training and education.

IRIS SDPC RNs are responsible for administering the Wisconsin Personal Care Screening Tool; creating person-centered plans of care; providing personal care oversight to a group of people in IRIS, providing education and training for IRIS participants and care providers, and conducting the required documentation and follow-up. As an IRIS SDPC RN, you'll play an important role in helping people of various backgrounds and abilities live their lives the way they choose.

Knowledge/Skills/Abilities

• Provides personal care assessments and oversight to the My Cares Groups by administering the Wisconsin Personal Care Screening Tool and addendums as required.

• Documents assessment as required by individual tool and Department of Health Services policies, and by completing oversight visits and calls as required.

• Oversees a My Cares Groups of participants, develops individual plans of care, ensures physician orders for care are obtained and reviews and revises plan of care as needed

• Submits for Prior Authorization for personal care services.

• Complies with all Department of Health Services policies and SDPC Guidelines, procedures, and practices along with documentation and program regulations.

• Provides personal care training to participants or care providers as requested and provides educational materials as needed.

• Completes collateral contacts with IRIS Consultants and Long-Term Care Functional Screeners and physicians to ensure care needs are met.

• Completes other duties as assigned.

Job Qualifications

REQUIRED EDUCATION:

Associates Degree in Nursing

REQUIRED EXPERIENCE:

• Minimum 2 years of experience in nursing with at least one year of home health serving individuals with developmental disabilities, physical disabilities, or the elderly.

• Demonstrated computer and software skills required, proficiency with Microsoft Office Suite and database operation/maintenance skills and data entry experience.

• Excellent written and verbal communication skills required and the ability to adapt communication styles to fit situation.

• Strong teaching and mentoring skills.

• Strong analytical and problem-solving skills.

• Good organizational and time management skills with ability to manage tasks independently.

• Flexibility in the work environment and willingness and ability to adapt to changing organizational needs.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

Current unrestricted license in the state of Wisconsin as a Registered Nurse.

Valid Driver's License

PREFERRED EDUCATION:

Bachelor's Degree in Nursing

PREFERRED EXPERIENCE:

Experience providing care through the Wisconsin Medicaid Personal Care Program or one year of home care experience

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: $18.04/hr - $35.17/hr*

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

Pay Range: $23.76 - $51.49 / HOURLY

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

Job Detail

• Company:
  Molina Healthcare

Job Description

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.

KNOWLEDGE/SKILLS/ABILITIES

• 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.

JOB QUALIFICATIONS

REQUIRED EDUCATION:

Any of the following:

Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or Master's Degree (preferably in a social science, psychology, gerontology, public health or social work or related

REQUIRED EXPERIENCE:

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

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

If license required for the job, 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.

STATE SPECIFIC REQUIREMENTS:

Roles serving Family Care and Family Care Partnership in the State of Wisconsin are required to have a Bachelor's Degree and a minimum of one year of professional experience.

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:

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, or 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.

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Builds company specific systems and technology expertise across multiple infrastructure and development disciplines

Knowledge/Skills/Abilities

- Responsible for task management and adherence to process controls.

- Responsible for troubleshooting and incident resolution for support functions.

- Contributes to on-call rotation schedules and off-hour support activities.

- Contributes to organize, manage and lead cross-team project tasks and deliverables.

- Contributes to the Infrastructure Solution Architect project design function.

- Contributes to solution architecture delivery within project management methodologies and timelines.

- Contributes to root cause analysis and problem solving.

- Contributes to tactical build and configuration activities.

- Provides cross-organization teamwork, collaboration, communication and leadership.

- Provides constructive feedback on people, process and technology for continuous improvement..

Job Qualifications

Required Education

- Bachelor's Degree.

Required Experience

1-4 years of IT technical experience with IT enterprise infrastructure.

Industry certifications preferred.

Experience in design and management of cloud-based network infrastructure.

Experience in network administration and support in a Microsoft server environment.

Experience with configuring and maintaining network switches, VLANS, routers, and firewalls.

Experience working in a large very complex organization.

Preferred Experience

Experience working within a health care organization.

Experience in a help desk, technology-oriented field, or on a technology support team.

Knowledge of Software-Defined Network (SDWAN), Local Area Networks (LANs), Wireless Local Area Networks (WLANS), and Wide Area Networks (WANs).

Experience utilizing Cisco security suite/tools.

Experience with a Virtual Private Network (VPN), with network monitoring tools or other SNMP monitoring software, and with system backup.

Enterprise (global) AD administration in a Multi-Domain Architecture.

Certifications below or comparable in network, network security and engineering

CISSP (Certified Information System Security Professional)

CISM (Certified Information Security Manager)

MCSE (Microsoft Certified Solutions Expert)

CCNA (Cisco Certified Network Associate) or CCNP (Cisco Certified Network Professional)

Pay Range: $60,415 - $117,809 a year*

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

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.

#PJCorp

#LI-BEMORE

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

TMG is on the lookout for our next great Eligibility Screener! If you love doing meaningful work that helps others live their best lives, we want to hear from you!

We're currently in search for someone with a background in human services, social work, healthcare or case management to join our team. This is a remote position, where you will partner with people in your community who use the TMG IRIS Consultant Agency. While this role is home-based, you will spend most days visiting IRIS participants in their homes. While you'll have a routine for the work that you do, no two days are alike!

As an Eligibility Screener, you would be responsible for completing the Adult Long-Term Care Functional Screens (LTC-FS) for participants of the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. The job includes completing annual rescreens and any change-in-condition screens using the Adult LTC-FS tool to ensure program eligibility. Successful candidates will be approachable, compassionate and respectful of people of all different backgrounds and abilities, and be able to see and articulate the strengths that people inherently have.

TMG is committed to maintaining a diverse and inclusive workforce, and prioritizes helping staff have a good work/life balance. Even though the position is remote, you'll have lots of support from your TMG team and coworkers across the organization. If this sounds like the job for you, apply today!

Job Duties

• Meets with IRIS participants face to face to complete the screening process.

• Completes the Adult Long Term Care Functional Screen (LTC-FS) for people in IRIS according to the Wisconsin Adult LTC-FS Instructions.

• Completes contacts to verify screen results with IRIS Consultants, Medicaid Personal Care agencies, and verifies diagnosis information with physicians and the Social Security Administration, when needed.

• Meets the highest standards of documentation and program regulations, while ensuring timely completion of screens.

• Maintains screening skills by participating in weekly team meetings, monthly All Screener Meetings, trainings and testing.

• Other duties as assigned by management.

Job Qualifications

REQUIRED EDUCATION :

Bachelor's Degree in a health or human services or related field. (e.g., social work, psychology) or graduate from an Accredited School of Nursing.

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :

• 1+ years of experience working with one of the target groups such as adults with physical or intellectual disabilities or older adults.

• Strong written and verbal communication skills; strong attention to detail.

• Demonstrated computer and software skills required; proficiency with Microsoft Office Suite and other software.

• Strong customer service skills.

• Good organizational and time management skills.

• The ability to work cooperatively as part of a team or autonomously

• Ability to remain flexible in the work environment and willing and able to adapt to changing organizational needs.

• Travel Requirements 5%

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION :

• Must pass the Wisconsin Adult Long-term Care Functional Screen certification modules (80% or higher on each module) within first week of hire and maintain certification as a screener.

• If a graduate from an Accredited School of Nursing, must have an active, unrestricted Wisconsin Registered Nursing (RN) license in good standing

• Must possess a valid driver's license, maintain adequate auto insurance for job-related travel and ability to travel throughout Wisconsin or other

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION :

Currently or formerly certified in the Long-Term Care Functional Screen.

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: $18.04/hr - $35.17/hr*

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

#PJHS

#LI-BEMORE

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Builds company specific systems and technology expertise across multiple infrastructure and development disciplines

Knowledge/Skills/Abilities

- Responsible for task management and adherence to process controls.

- Responsible for troubleshooting and incident resolution for support functions.

- Contributes to on-call rotation schedules and off-hour support activities.

- Contributes to organize, manage and lead cross-team project tasks and deliverables.

- Contributes to the Infrastructure Solution Architect project design function.

- Contributes to solution architecture delivery within project management methodologies and timelines.

- Contributes to root cause analysis and problem solving.

- Contributes to tactical build and configuration activities.

- Provides cross-organization teamwork, collaboration, communication and leadership.

- Provides constructive feedback on people, process and technology for continuous improvement..

Job Qualifications

Required Education

- Bachelor's Degree.

Required Experience

1-4 years of IT technical experience with IT enterprise infrastructure.

Industry certifications preferred.

Experience in design and management of cloud-based network infrastructure.

Experience in network administration and support in a Microsoft server environment.

Experience with configuring and maintaining network switches, VLANS, routers, and firewalls.

Experience working in a large very complex organization.

Preferred Experience

Experience working within a health care organization.

Experience in a help desk, technology-oriented field, or on a technology support team.

Knowledge of Software-Defined Network (SDWAN), Local Area Networks (LANs), Wireless Local Area Networks (WLANS), and Wide Area Networks (WANs).

Experience utilizing Cisco security suite/tools.

Experience with a Virtual Private Network (VPN), with network monitoring tools or other SNMP monitoring software, and with system backup.

Enterprise (global) AD administration in a Multi-Domain Architecture.

Certifications below or comparable in network, network security and engineering

CISSP (Certified Information System Security Professional)

CISM (Certified Information Security Manager)

MCSE (Microsoft Certified Solutions Expert)

CCNA (Cisco Certified Network Associate) or CCNP (Cisco Certified Network Professional)

Pay Range: $60,415 - $117,809 a year*

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

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.

#PJCorp

#LI-BEMORE

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Job Summary

Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you!

We're currently looking for someone with a social services or human services background to join our team. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS Program and the TMG IRIS Consultant Agency. While your office will be home-based, you will have regularly scheduled visits with IRIS participants in their home and community.

As an IRIS Consultant (IC), you will build relationships with the people you partner with and help them navigate and get the most out of the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. You can learn more about the IRIS program on the Wisconsin Department of Health Services website here (https://dhs.wisconsin.gov/iris/index.htm) . Together, you will identify the long-term care goals of the people enrolled in IRIS, and find creative ways to achieve those goals.

ICs play an important role in helping people of various backgrounds and abilities live the lives that they choose. In fact, people constantly tell us how supportive our ICs are and what a positive impact our ICs have had on their lives! Successful candidates for this position will be compassionate, genuine, resourceful partners with an eye for high quality work, and who are excited to work side-by side with people enrolled in IRIS.

As an IC, you will connect people to the resources available in their community. You will also help them develop customized IRIS plans for achieving their goals related to employment, housing, health, safety, community membership, transportation, and lasting relationships. While you will have a routine for the work that you do, no two days are alike!

TMG wants to find the best possible candidates, so we created this Realistic Job Preview to provide you with an inside look at the position and our organization. Find out more about the IRIS Consultant position by clicking on the link (https://www.youtube.com/watch?v=2vCojx1dK3I) and then reviewing the job posting below.

TMG is committed to maintaining a diverse and inclusive workforce and prioritizes helping staff have a good work/life balance. Even though the position is remote, you'll have lots of support from your TMG team and coworkers across the organization. If this sounds like the job for you, apply today!

KNOWLEDGE/SKILLS/ABILITIES

• Required to meet in person with the IRIS participant a minimum of four times per year, with one required annual visit in the home of the participant. Because IRIS is a self-directed program, it is important for ICs to be available upon the request of the participant.

• Responsible for providing program orientation to new participants. During this time, participants will learn their rights and responsibilities as someone enrolled in the IRIS program, including verifying legal documents, completing employee paperwork and the responsible use of public dollars.

• Explore a broad view of the participant's life, including goals, important relationships, connections with the local community, interest in employment, awareness of the Self-Directed Personal Care option, and back-up support plans.

• Assist participants in identifying personal outcomes and ensure those outcomes are being met on an ongoing basis, all while staying within the participant's IRIS budget and within the requirements of the IRIS program determined by the Department of Health Services (DHS).

• Responsible for documenting all orientation and planning activities within the IRIS data system (WISITs) within 48 business hours of the visit with the participant.

• Research community resources and natural supports that will fit the individual outcomes for each participant and share that information with them as it becomes available.

• Responsible for documenting progress and changes as needed within the plan and the data system anytime a modification is requested by a participant.

• Budget Amendment or One-Time Expense paperwork may be required depending upon factors associated with the participant and their individual IRIS budget.

• Educate participants on how to read and interpret their monthly budget reports to ensure that participants operate within their budget. Being a liaison between the Fiscal Employer Agency and the IRIS Consultant Agency is also a large part of the position, which includes assisting participants with provider billing, seeking support brokers, tracking receipts, ensuring their workers are paid and mitigating areas of potential risk or conflicts of interest.

• Responsible to develop engaged and trusting relationships with participants and communicate program changes and compliance effectively.

• Responsible to maintain confidentiality and HIPPA compliance.

• Work collaboratively with other IRIS Consultant Agency staff in order to ensure a successful implementation of participants' plans.

• Attend in-person monthly team meetings with other ICs and their supervisor. In addition, weekly IC and IRIS Consultant Supervisor phone check-ins may occur, along with other duties as assigned.

JOB QUALIFICATIONS

Required Education

Bachelor's degree in a social work, psychology, human services, counseling, nursing, special education, or a closely related field (or four years of commensurate experience if no degree).

Required Experience

• 1+ year of direct experience related to the delivery of social services to the target groups (individuals with intellectual or physical disabilities and older adults).

• Ability to work independently, with minimal supervision and be self-motivated.

• Knowledge of Long-Term Care programs and familiarity with principles of self-determination.

• Excellent problem-solving skills, critical thinking skills and strong basic math skills.

• Excellent time management and prioritization skills to focus on multiple projects simultaneously and adapt to change.

• Ability to develop and maintain professional relationships and work through situations without taking it personally.

• Comfortable working within a variety of settings and adjust style as needed; to work with a diverse population, various personalities, and personal situations.

• Resourceful and have knowledge of community resources while being proactive and detail oriented.

• Ability to use a variety of technology including but not limited to, Outlook, Skype, Teams, PowerPoint, Excel, Word, online portals and databases.

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.

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: $18.04/hr - $35.17/hr*

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

Pay Range: $16.23 - $35.17 / HOURLY

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

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you'll want to keep reading about this rewarding work opportunity!

We are currently looking for a Registered Nurse licensed in Wisconsin to become our next IRIS Self-Directed Personal Care (SDPC) RN. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. People in the IRIS program who need personal care services have the choice to enroll in the IRIS Self-Directed Personal Care (IRIS SPDC) option. You can learn more about IRIS SDPC on the Wisconsin Department of Health Services website here (https://dhs.wisconsin.gov/iris/sdpc.htm) , and learn about the IRIS program here (https://dhs.wisconsin.gov/iris/index.htm) . While this role is home-based, you will have regularly scheduled visits with people in their homes and communities.

As an IRIS SDPC RN, you'll provide oversight and guidance to the people enrolled in the IRIS SDPC option. You'll also build relationships with the people you partner with and ensure that they're getting the most out of the IRIS Self-Directed Personal Care option through assessment, oversight, training and education.

IRIS SDPC RNs are responsible for administering the Wisconsin Personal Care Screening Tool; creating person-centered plans of care; providing personal care oversight to a group of people in IRIS, providing education and training for IRIS participants and care providers, and conducting the required documentation and follow-up. As an IRIS SDPC RN, you'll play an important role in helping people of various backgrounds and abilities live their lives the way they choose.

Knowledge/Skills/Abilities

• Provides personal care assessments and oversight to the My Cares Groups by administering the Wisconsin Personal Care Screening Tool and addendums as required.

• Documents assessment as required by individual tool and Department of Health Services policies, and by completing oversight visits and calls as required.

• Oversees a My Cares Groups of participants, develops individual plans of care, ensures physician orders for care are obtained and reviews and revises plan of care as needed

• Submits for Prior Authorization for personal care services.

• Complies with all Department of Health Services policies and SDPC Guidelines, procedures, and practices along with documentation and program regulations.

• Provides personal care training to participants or care providers as requested and provides educational materials as needed.

• Completes collateral contacts with IRIS Consultants and Long-Term Care Functional Screeners and physicians to ensure care needs are met.

• Completes other duties as assigned.

Job Qualifications

REQUIRED EDUCATION:

Associates Degree in Nursing

REQUIRED EXPERIENCE:

• Minimum 2 years of experience in nursing with at least one year of home health serving individuals with developmental disabilities, physical disabilities, or the elderly.

• Demonstrated computer and software skills required, proficiency with Microsoft Office Suite and database operation/maintenance skills and data entry experience.

• Excellent written and verbal communication skills required and the ability to adapt communication styles to fit situation.

• Strong teaching and mentoring skills.

• Strong analytical and problem-solving skills.

• Good organizational and time management skills with ability to manage tasks independently.

• Flexibility in the work environment and willingness and ability to adapt to changing organizational needs.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

Current unrestricted license in the state of Wisconsin as a Registered Nurse.

Valid Driver's License

PREFERRED EDUCATION:

Bachelor's Degree in Nursing

PREFERRED EXPERIENCE:

Experience providing care through the Wisconsin Medicaid Personal Care Program or one year of home care experience

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: $18.04/hr - $35.17/hr*

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

Pay Range: $23.76 - $51.49 / HOURLY

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

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Builds company specific systems and technology expertise across multiple infrastructure and development disciplines

Knowledge/Skills/Abilities

- Responsible for task management and adherence to process controls.

- Responsible for troubleshooting and incident resolution for support functions.

- Contributes to on-call rotation schedules and off-hour support activities.

- Contributes to organize, manage and lead cross-team project tasks and deliverables.

- Contributes to the Infrastructure Solution Architect project design function.

- Contributes to solution architecture delivery within project management methodologies and timelines.

- Contributes to root cause analysis and problem solving.

- Contributes to tactical build and configuration activities.

- Provides cross-organization teamwork, collaboration, communication and leadership.

- Provides constructive feedback on people, process and technology for continuous improvement..

Job Qualifications

Required Education

- Bachelor's Degree.

Required Experience

1-4 years of IT technical experience with IT enterprise infrastructure.

Industry certifications preferred.

Experience in design and management of cloud-based network infrastructure.

Experience in network administration and support in a Microsoft server environment.

Experience with configuring and maintaining network switches, VLANS, routers, and firewalls.

Experience working in a large very complex organization.

Preferred Experience

Experience working within a health care organization.

Experience in a help desk, technology-oriented field, or on a technology support team.

Knowledge of Software-Defined Network (SDWAN), Local Area Networks (LANs), Wireless Local Area Networks (WLANS), and Wide Area Networks (WANs).

Experience utilizing Cisco security suite/tools.

Experience with a Virtual Private Network (VPN), with network monitoring tools or other SNMP monitoring software, and with system backup.

Enterprise (global) AD administration in a Multi-Domain Architecture.

Certifications below or comparable in network, network security and engineering

CISSP (Certified Information System Security Professional)

CISM (Certified Information Security Manager)

MCSE (Microsoft Certified Solutions Expert)

CCNA (Cisco Certified Network Associate) or CCNP (Cisco Certified Network Professional)

Pay Range: $60,415 - $117,809 a year*

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

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.

#PJCorp

#LI-BEMORE

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Builds company specific systems and technology expertise across multiple infrastructure and development disciplines

Knowledge/Skills/Abilities

- Responsible for task management and adherence to process controls.

- Responsible for troubleshooting and incident resolution for support functions.

- Contributes to on-call rotation schedules and off-hour support activities.

- Contributes to organize, manage and lead cross-team project tasks and deliverables.

- Contributes to the Infrastructure Solution Architect project design function.

- Contributes to solution architecture delivery within project management methodologies and timelines.

- Contributes to root cause analysis and problem solving.

- Contributes to tactical build and configuration activities.

- Provides cross-organization teamwork, collaboration, communication and leadership.

- Provides constructive feedback on people, process and technology for continuous improvement..

Job Qualifications

Required Education

- Bachelor's Degree.

Required Experience

1-4 years of IT technical experience with IT enterprise infrastructure.

Industry certifications preferred.

Experience in design and management of cloud-based network infrastructure.

Experience in network administration and support in a Microsoft server environment.

Experience with configuring and maintaining network switches, VLANS, routers, and firewalls.

Experience working in a large very complex organization.

Preferred Experience

Experience working within a health care organization.

Experience in a help desk, technology-oriented field, or on a technology support team.

Knowledge of Software-Defined Network (SDWAN), Local Area Networks (LANs), Wireless Local Area Networks (WLANS), and Wide Area Networks (WANs).

Experience utilizing Cisco security suite/tools.

Experience with a Virtual Private Network (VPN), with network monitoring tools or other SNMP monitoring software, and with system backup.

Enterprise (global) AD administration in a Multi-Domain Architecture.

Certifications below or comparable in network, network security and engineering

CISSP (Certified Information System Security Professional)

CISM (Certified Information Security Manager)

MCSE (Microsoft Certified Solutions Expert)

CCNA (Cisco Certified Network Associate) or CCNP (Cisco Certified Network Professional)

Pay Range: $60,415 - $117,809 a year*

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

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.

#PJCorp

#LI-BEMORE

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Opportunity for IL licensed LPN or a Bachelor/Masters trained Case Manager to service non-waiver members in the Champaign, IL service area. Duties, in part, included conducting face-to-face visits with our members in their homes. Schedule is Monday - Friday, 8 AM - 5 PM CST; mileage is reimbursed as part of our benefit package.

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.

KNOWLEDGE/SKILLS/ABILITIES

• 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.

JOB QUALIFICATIONS

REQUIRED EDUCATION:

Any of the following:

Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or Master's Degree (preferably in a social science, psychology, gerontology, public health or social work or related

REQUIRED EXPERIENCE:

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

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

If license required for the job, 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.

STATE SPECIFIC REQUIREMENTS:

Roles serving Family Care and Family Care Partnership in the State of Wisconsin are required to have a Bachelor's Degree and a minimum of one year of professional experience.

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:

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, or Licensed Marriage and Family Therapist (LMFT).

Pay Range: $24.00 - 46.81 per hour*

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

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.

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Opportunity for either an IL licensed LPN OR a Bachelors/Masters trained experienced Case Manager to work with EITHER waiver OR non-waiver membership in Cook County or the Collar Counties (DuPage, Kane, Lake, McHenry, and Will). Residing in the area is required as Case Managers will conduct face-to-face visits with our members in their homes. Schedule is Monday - Friday, 8 AM - 5 PM and mileage is reimbursed as part of our benefit package.

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.

KNOWLEDGE/SKILLS/ABILITIES

• 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.

JOB QUALIFICATIONS

REQUIRED EDUCATION:

Any of the following:

Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or Master's Degree (preferably in a social science, psychology, gerontology, public health or social work or related

REQUIRED EXPERIENCE:

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

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

If license required for the job, 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.

STATE SPECIFIC REQUIREMENTS:

Roles serving Family Care and Family Care Partnership in the State of Wisconsin are required to have a Bachelor's Degree and a minimum of one year of professional experience.

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:

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, or Licensed Marriage and Family Therapist (LMFT).

Pay Range: $24.00 - 46.81 per hour*

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

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.

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Opportunity for either an IL licensed LPN OR a Bachelors/Masters trained experienced Case Manager to work with EITHER waiver OR non-waiver membership in Cook County or the Collar Counties (DuPage, Kane, Lake, McHenry, and Will). Residing in the area is required as Case Managers will conduct face-to-face visits with our members in their homes. Schedule is Monday - Friday, 8 AM - 5 PM and mileage is reimbursed as part of our benefit package.

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.

KNOWLEDGE/SKILLS/ABILITIES

• 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.

JOB QUALIFICATIONS

REQUIRED EDUCATION:

Any of the following:

Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or Master's Degree (preferably in a social science, psychology, gerontology, public health or social work or related

REQUIRED EXPERIENCE:

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

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

If license required for the job, 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.

STATE SPECIFIC REQUIREMENTS:

Roles serving Family Care and Family Care Partnership in the State of Wisconsin are required to have a Bachelor's Degree and a minimum of one year of professional experience.

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:

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, or Licensed Marriage and Family Therapist (LMFT).

Pay Range: $24.00 - 46.81 per hour*

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

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.

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Builds company specific systems and technology expertise across multiple infrastructure and development disciplines

Knowledge/Skills/Abilities

- Responsible for task management and adherence to process controls.

- Responsible for troubleshooting and incident resolution for support functions.

- Contributes to on-call rotation schedules and off-hour support activities.

- Contributes to organize, manage and lead cross-team project tasks and deliverables.

- Contributes to the Infrastructure Solution Architect project design function.

- Contributes to solution architecture delivery within project management methodologies and timelines.

- Contributes to root cause analysis and problem solving.

- Contributes to tactical build and configuration activities.

- Provides cross-organization teamwork, collaboration, communication and leadership.

- Provides constructive feedback on people, process and technology for continuous improvement..

Job Qualifications

Required Education

- Bachelor's Degree.

Required Experience

1-4 years of IT technical experience with IT enterprise infrastructure.

Industry certifications preferred.

Experience in design and management of cloud-based network infrastructure.

Experience in network administration and support in a Microsoft server environment.

Experience with configuring and maintaining network switches, VLANS, routers, and firewalls.

Experience working in a large very complex organization.

Preferred Experience

Experience working within a health care organization.

Experience in a help desk, technology-oriented field, or on a technology support team.

Knowledge of Software-Defined Network (SDWAN), Local Area Networks (LANs), Wireless Local Area Networks (WLANS), and Wide Area Networks (WANs).

Experience utilizing Cisco security suite/tools.

Experience with a Virtual Private Network (VPN), with network monitoring tools or other SNMP monitoring software, and with system backup.

Enterprise (global) AD administration in a Multi-Domain Architecture.

Certifications below or comparable in network, network security and engineering

CISSP (Certified Information System Security Professional)

CISM (Certified Information Security Manager)

MCSE (Microsoft Certified Solutions Expert)

CCNA (Cisco Certified Network Associate) or CCNP (Cisco Certified Network Professional)

Pay Range: $60,415 - $117,809 a year*

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

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.

#PJCorp

#LI-BEMORE

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Opportunity for either an IL licensed LPN OR a Bachelors/Masters trained experienced Case Manager to work with EITHER waiver OR non-waiver membership in Cook County or the Collar Counties (DuPage, Kane, Lake, McHenry, and Will). Residing in the area is required as Case Managers will conduct face-to-face visits with our members in their homes. Schedule is Monday - Friday, 8 AM - 5 PM and mileage is reimbursed as part of our benefit package.

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.

KNOWLEDGE/SKILLS/ABILITIES

• 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.

JOB QUALIFICATIONS

REQUIRED EDUCATION:

Any of the following:

Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or Master's Degree (preferably in a social science, psychology, gerontology, public health or social work or related

REQUIRED EXPERIENCE:

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

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

If license required for the job, 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.

STATE SPECIFIC REQUIREMENTS:

Roles serving Family Care and Family Care Partnership in the State of Wisconsin are required to have a Bachelor's Degree and a minimum of one year of professional experience.

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:

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, or Licensed Marriage and Family Therapist (LMFT).

Pay Range: $24.00 - 46.81 per hour*

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

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.

Job Detail

• Company:
  Molina Healthcare

Job Description

Job Description

Job Summary

Builds company specific systems and technology expertise across multiple infrastructure and development disciplines

Knowledge/Skills/Abilities

- Responsible for task management and adherence to process controls.

- Responsible for troubleshooting and incident resolution for support functions.

- Contributes to on-call rotation schedules and off-hour support activities.

- Contributes to organize, manage and lead cross-team project tasks and deliverables.

- Contributes to the Infrastructure Solution Architect project design function.

- Contributes to solution architecture delivery within project management methodologies and timelines.

- Contributes to root cause analysis and problem solving.

- Contributes to tactical build and configuration activities.

- Provides cross-organization teamwork, collaboration, communication and leadership.

- Provides constructive feedback on people, process and technology for continuous improvement..

Job Qualifications

Required Education

- Bachelor's Degree.

Required Experience

1-4 years of IT technical experience with IT enterprise infrastructure.

Industry certifications preferred.

Experience in design and management of cloud-based network infrastructure.

Experience in network administration and support in a Microsoft server environment.

Experience with configuring and maintaining network switches, VLANS, routers, and firewalls.

Experience working in a large very complex organization.

Preferred Experience

Experience working within a health care organization.

Experience in a help desk, technology-oriented field, or on a technology support team.

Knowledge of Software-Defined Network (SDWAN), Local Area Networks (LANs), Wireless Local Area Networks (WLANS), and Wide Area Networks (WANs).

Experience utilizing Cisco security suite/tools.

Experience with a Virtual Private Network (VPN), with network monitoring tools or other SNMP monitoring software, and with system backup.

Enterprise (global) AD administration in a Multi-Domain Architecture.

Certifications below or comparable in network, network security and engineering

CISSP (Certified Information System Security Professional)

CISM (Certified Information Security Manager)

MCSE (Microsoft Certified Solutions Expert)

CCNA (Cisco Certified Network Associate) or CCNP (Cisco Certified Network Professional)

Pay Range: $60,415 - $117,809 a year*

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

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.

#PJCorp

#LI-BEMORE

Job Detail

• Company:
  Molina Healthcare

Job Description

JOB DESCRIPTION

Opportunity for a TX licensed RN to work as a Case Manager; part of the duties of the position include conducting face-to-face visits with our members in the Lake Jackson, TX service area. Schedule is Monday - Friday, 8 AM - 5 PM CST and mileage is reimbursed as part of our benefit package.

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.

KNOWLEDGE/SKILLS/ABILITIES

• Completes face-to-face comprehensive assessments of members per regulated timelines.

• Facilitates comprehensive waiver enrollment and disenrollment processes.

• Develops and implements a case management plan, including a waiver service 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.

• Performs ongoing monitoring of the 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, home and community to enhance the continuity of care for Molina members.

• Assesses for medical necessity and authorize all appropriate waiver services.

• Evaluates covered benefits and advise appropriately regarding funding source.

• Conducts face-to-face or home visits as required.

• Facilitates interdisciplinary care team 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, provides care coordination and assistance to member to address psycho/social, financial, and medical obstacles concerns.

• Identifies critical incidents and develops prevention plans to assure member's health and welfare.

• Provides consultation, recommendations and education as appropriate to non-RN case managers

• Works cases with members who have complex medical conditions and medication regimens

• Conducts medication reconciliation when needed.

• 50-75% travel required.

JOB QUALIFICATIONS

Required Education

Graduate from an Accredited School of Nursing

Required Experience

• At least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports.

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

• Required License, Certification, Association

• Active, unrestricted State Registered Nursing license (RN) in good standing

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

State Specific Requirements

Virginia: Must have at least one year of experience working directly with individuals with Substance Use Disorders

Preferred Education

Bachelor's Degree in Nursing

Preferred Experience

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

• 1 year experience working with population who receive waiver services.

Preferred License, Certification, Association

Active and unrestricted Certified Case Manager (CCM)

Pay Range: $26.41 - $51.49 per hour*

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

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.

Job Detail

• Company:
  Molina Healthcare