AMVETS Jobs

JOB DESCRIPTION

Job Summary

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

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

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

KNOWLEDGE/SKILLS/ABILITIES

Community Behavioral Health Support (CBHS) services is a new program beginning July 1, 2024. This benefit will help people who have a significant mental health diagnosis and need additional support to live in a community setting like an adult family home or an assisted living facility.

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

• Create and update authorizations.

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

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

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

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

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

JOB QUALIFICATIONS

Required Education

Any of the following:

• Completion of an accredited Licensed Vocational Nurse (LVN)

• Licensed Practical Nurse (LPN) Program

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

Required Experience

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

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

Required License, Certification, Association

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

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

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

Preferred Experience

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

UM Experience

Behavioral Health experience

Preferred License, Certification, Association

Any of the following:

• Transitions of Care Sub-Specialty Certification

• Licensed Clinical Social Worker (LCSW)

• Advanced Practice Social Worker (APSW)

• Certified Case Manager (CCM)

• Certified in Health Education and Promotion (CHEP)

• Licensed Professional Counselor (LPC/LPCC)

• Respiratory Therapist

• Licensed Marriage and Family Therapist (LMFT)

• One of the following licensures: LPN, LICSW, LMHC, LMHCA

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.