Healthcare - Care Manager II

Location: Remote MI (living within Wayne County or Macomb County)
Duration: 8 months
What is the typical schedule/shift going to be (i.e., 8am – 5pm)? 8:30-5 EST
Is this a temp to hire position? Potentially
Dual Monitors and docking station
Required Licensure / Education: RN, LBSW, LLMSW, LMSW

Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. · Has worked within MI Choice waiver or HCBS waiver program in Michigan · Reliable transportation with insurance · Strong internet connection


Essential Job Duties • Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. • Facilitates comprehensive waiver enrollment and disenrollment processes. • Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. • Performs ongoing monitoring of 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 (LTSS) and home and community resources to enhance continuity of care. • Assesses for medical necessity and authorizes all appropriate waiver services. • Evaluates covered benefits and advises appropriately regarding funding sources. • Facilitates interdisciplinary care team (ICT) 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 and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. • Identifies critical incidents and develops prevention plans to assure member health and welfare. • Collaborates with licensed care managers/leadership as needed or required. • 50% estimated local travel may be required (based upon state/contractual requirements).

Required Years of Experience: • At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.

Must Have Skills: • Demonstrated knowledge of community resources. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to operate proactively and demonstrate detail-oriented work. • Ability to work independently, with minimal supervision and self-motivation. • Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving, and critical-thinking skills. • Strong verbal and written communication skills.