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 Specialist

Pay Range: $16.4 - $31.97 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.