Licensed Social Worker Case Manager - Dayton OH

Molina Healthcare • Cedarville, OH

415d • $49,920 - $116,834

About The Position

The Licensed Social Worker Case Manager will support the MMP Waiver Program at Molina Healthcare, focusing on providing integrated care for members with high needs. This role involves conducting assessments, developing care plans, and coordinating services to ensure quality care. The position requires excellent computer skills, attention to detail, and the ability to multitask in a fast-paced environment, with both telephonic and face-to-face interactions with members.

Requirements

• Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or master's degree in a social science, psychology, gerontology, public health or social work.
• 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.

Nice To Haves

• 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.
• Active and unrestricted Certified Case Manager (CCM) certification.
• Active, unrestricted State Nursing license (LVN/LPN) OR Clinical Social Worker license in good standing.

Responsibilities

• Complete face-to-face comprehensive assessments of members per regulated timelines.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement a case management plan in collaboration with the member and healthcare professionals.
• Perform ongoing monitoring of the care plan to evaluate effectiveness and suggest changes accordingly.
• Promote integration of services for members including behavioral health care and long-term services and supports.
• Assess for medical necessity and authorize all appropriate waiver services.
• Evaluate covered benefits and advise appropriately regarding funding sources.
• Conduct face-to-face or home visits as required.
• Facilitate interdisciplinary care team meetings for approval or denial of services.
• Use motivational interviewing to educate and support members during contacts.
• Assess for barriers to care and provide care coordination to address concerns.
• Identify critical incidents and develop prevention plans to assure member's health and welfare.

Benefits

• Competitive pay range of $24 - $56.17 per hour.
• Mileage reimbursement for travel.
• Comprehensive benefits package including health insurance, dental insurance, and retirement plans.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Associate degree