Molina Healthcare
Location: Milwaukee,WI, USA
Date: 2024-12-17T23:36:28Z
Job Description:
**Molina Healthcare** is hiring for a **Care Coordinator.** This role is remote with a preference for location being in/near southeastern Wisconsin.The (non-clinical) Care Coordinator works with members, providers and multidisciplinary team members, focusing on specific HEDIS measures- Asthma,Diabetes and Hypertension. This role will 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.Highly Qualified Applicants will have the following qualifications-+ A passion for providing the education needed to members to help manage and improve chronic health conditions.+ Background or experience in social work, community health, Community Health Worker (CHW), public health, health education, Certified Health Education Specialist (CHES), or the like.+ Above average computers skills (able to work proficiently in MS Outlook, Word, Excel)**Job Duties**+ Performs care coordination activities in collaboration with health care providers, other HCS staff, involved medical case managers, case management processors, community-based organizations (CBOs), and other providers as required to provide timely and accurate service authorizations and integrated care.+ Assist members with social determinant of health needs, challenges in accessing health & community resources or other needs that fragment care and lead to poor health outcomes.+ Documents all findings, contacts, and interventions in the electronic care management system.+ Collaborates with state agencies, healthcare professionals and community support systems promote integrated care.+ Expected to meet daily production standards in terms of member outreach.+ Provide face-to-face care coordination activities in the communities where members reside.+ Assesses for barriers to care, provides care coordination and assistance to member to address psychosocial, financial, and medical obstacle concerns.+ Accurately interprets specific state and/or federal benefits, contracts as well as additional business requirements and converting these terms to configuration parameters.+ Coordinating the authorization of needed services such as timely approval of durable medical equipment, pharmacy, and medical supplies.+ Ensuring access to Medically Necessary physical health or Behavioral Health through assisting with appointments and transportation services.+ Provides coaching/information for available health services or health education+ \#LI-TR1**Job Qualifications****Required Education:**+ Bachelor's Degree in a health care related field; however, relevant experience will be considered in lieu of degree.**Required Experience:**+ Para-professional whose background is anchored in social work or community health systems - per contract can be non-licensed.+ Min. 1 year clinical experience**Preferred Qualifications:**+ Experience in social services, medical terminology+ Experience in managed care environment; including knowledge or applicable state and federal regulations and standards.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.Key Words: HEDIS, CHES, Certified Health Education Specialist, WI, Public Health, Health Education, Communication, Instructional Skills, Training, Member Training, Teacher, Training, Health Education, CHW, Community Health Worker, Social Work, Case Management, Non-Clinical Case Management, Case Care, Case SpecialistPay Range: $16.4 - $31.97 / HOURLY*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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