Current residents of California Preferred 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 Oversees an integrated Care Access and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/utilization review, and/or other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Functions as a hands-on supervisor, coordinating and monitoring clinical and non-clinical team activities to...

JOB DESCRIPTION Job SummaryProvides support for long-term care screening processes and coordination for older adults and adults with physical or intellectual disabilities. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties Schedules appointments with members to complete home based long-term care functional screen (LTCFS) assessments. Uses the Wisconsin LTCFS to gather information about member functional abilities, health status, and personal/professional supports. Completes the LTCFS in a collaborative manner with the member, family, other member supports, and the member interdisciplinary care team (ICT). Coordinates with member ICT to ensure new enrollment, annual, and change in member condition screens are completed. Ensures consistency between data gathered during the functional assessment and member-specific data contained in the member record. Uses spreadsheets to track and ensure adherence to LTCFS timeframes....