Company Detail

IRIS Consultant (Madison, WI) (Fieldwork/Hybrid) (No Weekends, No Holidays, No After Hours) - Molina Healthcare
Posted: Nov 10, 2023 07:32
MADISON, WI

Job Description

JOB DESCRIPTION

Job Summary

IDo 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.

Pay Range: $18.04 - $35.17 an 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

Case Management Processor - Molina Healthcare
Posted: Nov 10, 2023 07:32
DOWNERS GROVE, IL

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

  • Provides telephone, clerical, and data entry support for the Case Management team.

  • Responsible for initial review of assigned case levels to assist in Case Management assignment.

  • Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plan.

  • Schedules member visits with team members as needed.

  • Screens members using Molina policies and processes, assisting clinical Case Management staff as they identify appropriate medical services.

  • Coordinates required services in accordance with member benefit plan.

  • Promotes communication, both internally and externally to enhance effectiveness of case management services.

  • Processes member and provider correspondence.

JOB QUALIFICATIONS

Required Education

HS Diploma or GED

Required Experience

1-3 years' experience in an administrative support role in healthcare.

Preferred Education

Associate degree

Preferred Experience

3+ years' experience in an administrative support role in healthcare, Medical Assistant preferred.

Pay Range: $14.90 - 29.06 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: $13.41 - $29.06 / HOURLY

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



Job Detail

Engineer, EIS - Networking (Hybrid On Site in Madison, WI) - Molina Healthcare
Posted: Nov 10, 2023 07:32
COLUMBUS, WI

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

Case Management Processor - Molina Healthcare
Posted: Nov 10, 2023 07:32
DOWNERS GROVE, IL

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

  • Provides telephone, clerical, and data entry support for the Case Management team.

  • Responsible for initial review of assigned case levels to assist in Case Management assignment.

  • Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plan.

  • Schedules member visits with team members as needed.

  • Screens members using Molina policies and processes, assisting clinical Case Management staff as they identify appropriate medical services.

  • Coordinates required services in accordance with member benefit plan.

  • Promotes communication, both internally and externally to enhance effectiveness of case management services.

  • Processes member and provider correspondence.

JOB QUALIFICATIONS

Required Education

HS Diploma or GED

Required Experience

1-3 years' experience in an administrative support role in healthcare.

Preferred Education

Associate degree

Preferred Experience

3+ years' experience in an administrative support role in healthcare, Medical Assistant preferred.

Pay Range: $14.90 - 29.06 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: $13.41 - $29.06 / HOURLY

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



Job Detail

Engineer, EIS - Networking (Hybrid On Site in Madison, WI) - Molina Healthcare
Posted: Nov 10, 2023 07:32
WISCONSIN DELLS, WI

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

Director, Broker Services - Molina Healthcare
Posted: Nov 10, 2023 07:32
IRVING, TX

Job Description

Job Description

Job Summary

Responsible for direction and oversight of the functions of Broker Services. This includes strategy and execution of a sales and growth support model for the Medicare, Medicaid and Marketplace lines of business. The role owns the administrative responsibility for ensuring all agents, brokers and others involved in the enrollment of new members and supported by multiple teams of specialists and coordinators facilitating onboarding, credentialing, certification and support of brokers, their leadership teams and the internal sales leadership team.

Knowledge/Skills/Abilities

- Ensure departmental compliance for the sales organization

  • Oversee broker onboarding

  • Maintain broker hierarchy system of record

  • Oversee operations to respond to inbound broker issues

- Provide Leadership and development opportunities to operations teams, while working closely with other units to enhance business growth opportunities.

- Develop strategic priorities for operational efficiency across multiple business units.

- Meet key business operational goals on time and within budget.

- Monitor, analyze and report on key performance indicators

- Develop and coordinate the implementation of department-wide initiatives and activities by working collaboratively with strategic partners, Health Plans and other internal impacted areas.

- - Work with other departments to assess and improve/create workflow processes.

- Identify areas of opportunities for improvement, which to include establishing productivity metrics and expected outcomes.

- Maintain oversight committee for broker oversight

- Participate in workgroups related to all areas of business operations.

- Organize, facilitate and report on meetings that contribute to the overall success of the department initiatives, workflows and or outcomes.

- Assist with creating, documenting and implementing policies and procedures to maximize efficiency.

- Provide guidance, mentoring and coaching to staff related to performance and handle disciplinary actions.

- Conduct research on federal, state, and local quality compliance guidelines and when appropriate, communicate updates and changes to teams.

  • 7 years in Health Care and Quality Operations

  • Previous experience in Government Programs

  • Ability to create, review, analyze and present operational productivity reports.

- Ability to assess skills, mentor staff and promote growth within the Molina team.

- Excellent interpersonal skills, including the ability to communicate professionally, both verbally and in writing.

- Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.

- Proficient on MS Office Suite. Strong business acumen and technical skills.

- Willingness to maintain a flexible work schedule as needed.

- Ability to abide by Molina's policies.

- Maintain regular attendance based on agreed-upon schedule.

- Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA) and Protected Health Information (PHI) Regulations.

Job Qualifications

REQUIRED EDUCATION:

Associate's Degree or equivalent combination of education and experience

PREFERRED EXPERIENCE:

5 years in Health Care and Quality Operations

PHYSICAL DEMANDS:

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

Pay Range: $97,299 - $189,732 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.

Pay Range: $87,568.7 - $189,732.18 / ANNUAL

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



Job Detail

Field Case Manager - LPN or Social Worker - Molina Healthcare
Posted: Nov 10, 2023 07:32
WAUKEGAN, IL

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

Field Case Manager - LPN or Social Worker - Molina Healthcare
Posted: Nov 10, 2023 07:32
WAUKEGAN, IL

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

Field Case Manager - non-waiver - Molina Healthcare
Posted: Nov 10, 2023 07:32
SPRINGFIELD, IL

Job Description

JOB DESCRIPTION

Opportunity for IL licensed LPN or a Bachelor/Masters trained Case Manager to service non-waiver members in central Illinois. 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

Field Case Manager (RN) - Molina Healthcare
Posted: Nov 10, 2023 07:32
COLUMBUS, OH

Job Description

JOB DESCRIPTION

Opportunity for an Ohio licensed RN residing in the metro Columbus, OH area to work as a Case Manager; part of the responsibilities of this role is to meet with members in their homes for face-to-face visits. 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 comprehensive 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 identified in 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 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/home and community to enhance the continuity of care for Molina members.

  • 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.

  • 25- 40% local travel required.

  • RNs provide consultation, recommendations and education as appropriate to non-RN case managers.

  • RNs are assigned cases with members who have complex medical conditions and medication regimens

  • RNs conduct medication reconciliation when needed.

JOB QUALIFICATIONS

Required Education

Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.

Required Experience

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 (RN) license in good standing.

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

Preferred Education

Bachelor's Degree in Nursing

Preferred Experience

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

Preferred License, Certification, Association

Active, 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

Field Case Manager - LPN or Social Worker - Molina Healthcare
Posted: Nov 10, 2023 07:32
WOODSTOCK, IL

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

Engineer, EIS - Networking (Hybrid On Site in Madison, WI) - Molina Healthcare
Posted: Nov 10, 2023 07:32
BELOIT, WI

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

Field Case Manager - LPN or Social Worker - Molina Healthcare
Posted: Nov 10, 2023 07:32
WOODSTOCK, IL

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

IRIS Consultant (Sawyer/Washburn Counties) (Fieldwork/Hybrid) (No Weekends, No Holidays, No After Hours) - Molina Healthcare
Posted: Nov 10, 2023 07:32
HAYWARD, WI

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

Field Case Manager - non-waiver - Molina Healthcare
Posted: Nov 10, 2023 07:32
PEORIA, IL

Job Description

JOB DESCRIPTION

Opportunity for IL licensed LPN or a Bachelor/Masters trained Case Manager to service non-waiver members in the Peoria, 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

Field Case Manager - LPN or Social Worker - Molina Healthcare
Posted: Nov 10, 2023 07:32
WHEATON, IL

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

Field Case Manager, LTSS (RN) - Molina Healthcare
Posted: Nov 10, 2023 07:32
DALLAS, TX

Job Description

JOB DESCRIPTION

Position is available to TX licensed RN who is interested in working as a Case Manager in the Dallas service area. Meeting with members in their home for a face-to-face visit is part of the responsibilities. Candidates with Case Manager experience with a health insurance company or in home health are preferred. Schedule is Monday - Friday, 8 AM - 5PM, and mileage is reimbursed as parr of the 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

Engineer, EIS - Networking (Hybrid On Site in Madison, WI) - Molina Healthcare
Posted: Nov 10, 2023 07:32
BELOIT, WI

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

Field Case Manager - LPN or Social Worker - Molina Healthcare
Posted: Nov 10, 2023 07:32
WHEATON, IL

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

Case Manager ($5K Signing Bonus) (Must reside in WI) -Field travel in Janesville, WI - Molina Healthcare
Posted: Nov 10, 2023 07:32
JANESVILLE, WI

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

IRIS SDPC (RN) (Fieldwork/Hybrid) (No Weekends, No Holidays, No After Hours) - Molina Healthcare
Posted: Nov 08, 2023 08:26
MILWAUKEE, WI

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: $26.41/hr - $51.49/hr*

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



Job Detail

IRIS Consultant (Fieldwork/Hybrid) (No Weekends, No Holidays, No After Hours) - Molina Healthcare
Posted: Nov 08, 2023 08:26
MILWAUKEE, WI

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.



Job Detail

IRIS Consultant (Fieldwork/Hybrid) (No Weekends, No Holidays, No After Hours) - Molina Healthcare
Posted: Nov 08, 2023 08:26
FRANKLIN, WI

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.



Job Detail

IRIS Consultant (Fieldwork/Hybrid) (No Weekends, No Holidays, No After Hours) - Molina Healthcare
Posted: Nov 08, 2023 08:26
OAK CREEK, WI

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.



Job Detail

Facilitated Enroller Sales - Field Position (Buffalo, NY) - Molina Healthcare
Posted: Nov 08, 2023 08:26
BUFFALO, NY

Job Description

JOB DESCRIPTION

Job Summary

The Marketplace Facilitated Enroller (MFE) is responsible for identifying prospective members that do not have health insurance and assisting with the enrollment process ultimately making it easier for them to connect to the care they need. The MFE conducts interviews and screens potentially eligible recipients for enrollment into Government Programs such as Medicaid/Medicaid Managed Care, Child Health Plus and Essential Plan. Additionally, the MFE will assist in enrollment into Qualified Health Plans. The MFE must offer all plans and all products. MFEs assist families with their applications, provides assistance with completing the application, gathers the necessary documentation, and assists in selection of the appropriate health plan. The Enroller provides information on managed care programs and how to access care. The MFE is responsible for processing paperwork completely and accurately, including follow up visit documentation and other necessary reports. The MFE is also responsible for assisting current members with recertification with their plan. MFEs must source, develop and maintain professional, congenial relationships with local community agencies as well as county and state agency personnel who refer potentially eligible recipients.

KNOWLEDGE/SKILLS/ABILITIES

  • Responsible for achieving monthly, quarterly, and annual enrollment goals and growth targets, as established by management.

  • Interview, screen and assist potentially eligible recipients with the enrollment process into Medicaid/Medicaid Managed Care, Child Health Plus the Essential Plan and Qualified Health Plans for Molina and other plans who operate in our service area

  • Meet with consumers at various sites throughout the communities

  • Provide education and support to individuals who are navigating a complex system by assisting consumers with the application process, explaining requirements and necessary documentation

  • Identify and educate potential members on all aspects of the plan including answering questions regarding plan's features and benefits and walking client through the required disclosures

  • Educate members on their options to make premium payments, including due dates

  • Assist clients with choosing a plan and primary care physician

  • Submit all completed applications, adhering to submission deadline dates as imposed by NYSOH and Molina enrollment guidelines and requirements

  • Responsible for identifying and assisting current members who are due to re-certify their healthcare coverage by completing the annual recertification application including adding on additional eligible family members

  • Respond to inquiries from prospective members and members within the marketing guidelines

  • Must adhere to all NYSOH rules and regulations as applicable for MFE functions

  • Outreach Projects

  • Participate in events and community outreach projects to other agencies as assigned by Management for a minimum of 8 hours per week

  • Establish and maintain good working relationships with external business partners such as hospital and provider

  • organizations, city agencies and community-based organizations where enrollment activities are conducted

  • Develop and strengthen relations to generate new opportunities

  • Attend external meetings as required

  • Attend community health fairs and events as required

  • Occasional weekend or evening availability for special events.

JOB QUALIFICATIONS

Required Education

HS Diploma

Required Experience

  • Minimum one year of experience working with State and Federal Health Insurance programs and populations

  • Demonstrated organizational skills, time management skills and ability to work independently

  • Ability to meet deadlines

  • Excellent written and oral communication skills; strong presentation skills

  • Basic computer skills including Microsoft Word and Excel

  • Strong interpersonal skills

  • A positive attitude with ability to adapt to change

  • Must have reliable transportation and a valid NYS drivers' license with no restrictions

  • Knowledge of Managed Care insurance plans

  • Ability to work with a diverse population, including different ethnicities, cultural backgrounds, and/or underserved communities

  • Ability to work a flexible schedule, including nights and weekends

Required License, Certification, Association

Successful completion of the NYSOH required training, certification and recertification

Preferred Education

AA/AS - Associates degree

Preferred Experience

Previous experience as a Marketplace Facilitated Enroller - Bilingual

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: $16.40- $31.97 hourly*

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

#PJED

#LI-BEMORE



Job Detail