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Molina Healthcare jobs in Chicago, IL

- 67 jobs
  • Care Manager, LTSS (Must Reside in Southern Cook County)

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Joliet, IL

    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. 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. • 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications • 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. •Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • 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. • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). Preferred Qualifications • Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. • Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $25.2 - $49.15 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $25.2-49.2 hourly 1d ago
  • Care Manager, LTSS (Must Reside in Southern Cook County)

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Evanston, IL

    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. 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. • 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications • 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. •Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • 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. • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). Preferred Qualifications • Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. • Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $25.2 - $49.15 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $31k-37k yearly est. 1d ago
  • Material Handler - First Shift- Manteno, IL

    McKesson 4.6company rating

    Manteno, IL job

    McKesson is seeking dynamic & engaging individuals to fill multiple Material Handler roles in our distribution center located in Manteno, IL. This will be a contract role with a potential opportunity to expand into a permanent position based on business needs and performance. If we gained your interest in learning more about McKesson, we encourage you to apply by clicking I'M INTERESTED below. If you are passionate about inspiring, motivating, and assisting our team, this opportunity could further enhance our journey and we want to hear from you. Day to day we will be servicing our customers in receiving the medical supplies needed to improve their quality of life. From day one, you will be able to create a positive culture for the entire DC, that reinforces our McKesson values. Our Current Hiring Need is Material Handlers First Shift Pay Rate: $21.99/hr. Job Description Performing the physical tasks involved in the shipping, receiving, storing, and distributing medical products Pulls and fills orders. Working with RF Scanning equipment to maintain records of merchandise shipped, as well as examine, stock, and distribute materials in inventory and on manufacturing lines. Preparing goods for final shipment. Will use power equipment including, but not limited to forklift, hand tools, and other devices operated in a warehouse environment while maintaining the highest level of productivity and accuracy. Standing and engaging in repetitive movement throughout the entire shift. Extensive walking and mandatory overtime as needed is required. Passion around working for a leading healthcare distribution company focused on distributing pharmaceuticals to more than 40,000 customers ranging from retail chains, independent retail pharmacies, hospitals, health systems, and other healthcare facilities. If you like the sound of these job tasks and perks, then starting your career as a Material Handler is right for you! Keep Your Edge - Stay mentally sharp throughout your shift picking, checking, or packing orders as you strategically get the job done. Stay Fit -Get your workout in as you bend, twist, lift up to 50lbs, and walk extensive miles per shift. Take advantage of possible on the job training to operate power equipment and get certified! Our Distribution Centers is climate controlled and utilizes state of the art systems & equipment. Stay comfortable while working in a fast-paced team-oriented environment! Qualifications Qualifications 0-1+ year experience. Prefer experience working with Warehouse Equipment (Power Industrial Equipment, Forklift, Cherry Picker, Pallet Jack, etc.). The ability to read, write, speak and understand English in order to work independently and to communicate about, understand and follow job and safety-related instructions and rules. Critical Skills: Working knowledge of Material Handling issues. Work experience in a fast-paced, distribution or warehouse environment or stock room strongly preferred; picking/packing, sorting, loading/unloading, scanning, quality inspection or various other warehouse functions. The ability to work the hours listed above, in addition to overtime. * Overtime in most Distribution Centers is mandatory and typically occurs M-W due to our real-time commitments to our customers. Strong reading, addition and subtraction skills needed to manage order specific documentation. Additional Information All your information will be kept confidential according to EEO guidelines.
    $22 hourly 60d+ ago
  • Home Health Aide

    Humana Inc. 4.8company rating

    Buffalo Grove, IL job

    Become a part of our caring community and help us put health first A Home Health Aide ( HHA ): * Provides direct patient care to patient under direction of the RN and according to the Aide Plan of Care (POC). * Correctly assists the patient with self-administered medications by opening bottle caps for the patient, reading medication labels to the patient, checking the dose being self-administered against the prescribed dose on the container label and observing the patient takes the medication * Consistently takes accurate temperature, pulse and blood pressure measurements and recognizes and reports abnormal results to supervisor * Helps patient maintain good personal hygiene by performing or supervising bathing, grooming, skin care, shaving, oral care, nail/foot care and other activities * Assists in feeding patients. Is able to communicate basic principles of nutrition, observe and record food and fluid intake when necessary. Safely positions patient for meals and feeds or assists in self feeding * Assists with patient toileting including use of bed pan/urinal, change and position catheter bags and bag change procedures on well-regulated ostomies * Provides necessary skills to safely assist the patient with patient mobility, exercises, positioning/turning, transfers and ambulation per Plan of Care and CenterWell Home Health policy * Provides necessary skills to appropriately report changes and document pertinent information and care rendered to patient to ensure continuity of care. Documents interactions with patients, caregivers, doctors and other staff members appropriately, legibly, thoroughly and in the amount of time allowed * Practice acceptable infection control principles. Provide a clean, safe and comfortable environment * Willingly assists with other household duties including light laundry, bed changing and bed making, light meal preparation, light housekeeping and shopping (if no other assistance is available and an MD order is present). Use your skills to make an impact Required Experience/Skills: * High school diploma or equivalent * Completion of Certified Nursing Assistant or Certified Home Health Aide Program within the last 24 months * Must meet applicable state certification requirements * A valid driver's license, auto insurance, and reliable transportation are required * Must be in good standing on the HHA Registry (if applicable) and have completed HHA/CNA course to work for a Medicare certified agency. * At least one year experience in the last 24 months as a Home Health Aide or Certified Nursing Assistant in a hospital, nursing home, home health/hospice agency. Scheduled Weekly Hours 1 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $41,300 - $48,200 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $41.3k-48.2k yearly 34d ago
  • LTSS Service Care Coordinator

    Centene Corporation 4.5company rating

    Naperville, IL job

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. *****NOTE: This is a hybrid-remote role with 50% local travel for visits to assist members residing in Supportive Living facilities (SLFs). Preference will be given to applicants with waiver, case management, advocacy or home visits/community travel experience who reside near Chicago, IL in either Lake, Cook or McHenry county.** **- Business: Illinois Health Plan** **- Department: LTSS Case Management** **- Caseload: Supportive Living Facility** **members** **- Schedule: Monday through Friday, 8-4:30 pm CT; 30 min lunch ***** **Position Purpose:** Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs. + Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome + Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care + Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members + Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans + Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs + Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met + Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators + May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate + Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits + Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner + Performs other duties as assigned + Complies with all policies and standards **Education/Experience:** Requires a Bachelor's degree and 1 year of related experience. **For Illinois Plan Only: In addition to the requirements above the employee working on** **Physically Disabled/Elderly** Candidate must meet one of the 3 following criteria: 1. RN licensed in Illinois. 2. Bachelor or Master's Degree prepared in human services related field. Bachelor's degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology. 3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly Pay Range: $22.50 - $38.02 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $22.5-38 hourly 46d ago
  • MCO Government Contracts Sr. Specialist (Illinois Experience Needed)

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Chicago, IL

    Molina Healthcare is hiring a Sr Specialist in our Government Contracts department. This role is remote with a high preference for candidates who reside in Illinois. The Sr Specialist in our Government Contracts will be responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations. You will also Intake state correspondence for Government Contract SharePoint logs, assign internally, and track to completion. Provide timely responses to external regulators on all requests. Attend and take notes for HFS meetings. Track Member/Provider complaints along with the impact on customer experience with Molina to improve on all levels. **Highly qualified candidates will have the following experience-** + Live in Illinois and are familiar with Managed Care in Illinois and how HHF operates. + Background/experience in business analytics, deadline tracking, previous experience researching and interpreting contract language is also a plus. + Great at building relationships and working across departments, able to articulate GC expectations for deliverables and interpret regulator instructions. + Comfortable speaking with all levels of leadership. **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for coordinating, conducting and/or responding to research requests pertaining to government healthcare programs; preparing and submitting regulatory reports for filings; reviewing Plan submissions for quality, accuracy, and timeliness; and ensuring Plan meets contractual and regulatory requirements. + Reviews Provider Agreement, EOC/ Member Handbook, Provider Directory, marketing materials, and other contract reporting deliverables for compliance with contractual and regulatory requirements prior to submission. + Assesses information received from government contracting agencies and regulators and disseminates to impacted Plan staff. + Participates in meetings related to Molina government run programs with State agencies and Molina Corporate departments and disseminates relevant information to staff and management. + Oversees/maintains the department's documentation and archive system, ensuring submitted reports are archived for historical and audit purposes. Ensures system is updated and complete. **JOB QUALIFICATIONS** **Required Education** : High School diploma or equivalent **Preferred Education** : Bachelor's Degree in Business Administration, Healthcare, or related field. **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrates strong: communication and presentation skills; analytical/reasoning ability; detail orientation; organizational and interpersonal skills. + Proficient in compiling data, creating reports, and presenting information, using Crystal Reports (or similar reporting tools), SQL query, MS Access, and MS Excel. 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: $47,660 - $88,511.46 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $47.7k-88.5k yearly 60d+ ago
  • Director, Workforce Management

    McKesson Corporation 4.6company rating

    Chicago, IL job

    McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. Job Summary We are seeking a leader for our Workforce Management team to join our team in Richmond, VA or any location near an McKesson Medical Surgical (MMS) distribution center. This position will be responsible for designing and implementing our workforce management solution. The position is the decision maker for the planning, project management oversight, and implementation of the project as well as ongoing administration of the program. Key Responsibilities: Strategic Leadership: * Develop and implement network-wide workforce management strategy * Lead WFM teams in forecasting, scheduling, and real-time management across multiple distribution centers. * Partner with senior leadership to align labor planning with financial and operational targets. * Serve as a thought leader in workforce strategy, contributing to labor initiatives and transformation efforts. Forecasting & Planning: * Oversee long-term and short-term labor forecasting models using historical data, seasonal trends, and predictive analytics. * Collaborate with Finance and Operations to support budgeting and headcount planning. * Integrate AI/ML models to enhanced forecasting accuracy and responsiveness to demand fluctuations. Scheduling & Optimization: * Ensure efficient scheduling practices that balance labor costs with service level goals. * Implement tools and technologies to automate and optimize scheduling processes. * Design scalable scheduling frameworks adaptable to future growth and automation. Performance Monitoring: * Establish KPIs and dashboards to monitor workforce performance and productivity. * Drive continuous improvement through data analysis and actionable insights. * Benchmark performance across sites to identify best practices and standardize excellence. Technology & Systems: * Evaluate and implement WFM software solutions. * Ensure system integrity, data accuracy, and user adoption across the organization. Compliance & Governance: * Ensure adherence to labor laws and internal policies. * Maintain documentation and audit readiness for workforce-related processes. Team Development: * Lead, mentor, and develop a high-performing WFM team. * Foster a culture of accountability, innovation, and collaboration. Minimum Requirements * 4-year degree in business or related field strongly preferred, or equivalent experience * 12+ years in workforce management or operations * 5+ years experience leading teams and projects in a large, complex company * Excellent verbal and written communication skills * Ability to engage and influence people across the organization * Effective time management and multitasking skills * Experience with enterprise WFM platforms (Kronos, ADP, Reflexis, Blue Yonder) * Strong analytical skills with proficiency in tools like SQL, Power BI, or Tableau. Preferred Skills * Lean or six sigma certification * Risk and planning analysis #LI-JT2 We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here. Our Base Pay Range for this position $111,200 - $185,300 McKesson is an Equal Opportunity Employer McKesson provides equal employment opportunities to applicants and employees and is committed to a diverse and inclusive environment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age or genetic information. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page. Join us at McKesson!
    $111.2k-185.3k yearly Auto-Apply 35d ago
  • RN Clinical Manager

    Humana Inc. 4.8company rating

    Joliet, IL job

    Become a part of our caring community and help us put health first Work Schedule: Full-time/40 Hours On-site This is not a remote or work-from-home position. This position requires you to sit on-site at our Joliet, IL branch location. The RN Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. This role is a focused on both home health clinical quality assurance and home health clinical operations initiatives. * Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. * Conducts/delegates the assessment and reassessment of patients, including updating of care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures/policies. * Manages the assignment of caregivers. * Responsible for and oversees the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet admission criteria and make the decision to admit patients to service. Assigns appropriate clinicians to a case, as needed. * Instructs and guides clinicians to promote more effective performance and delivery of quality home care services and is available at all times during operating hours to assist clinicians as appropriate. * Assists clinicians in establishing immediate and long-term therapeutic goals, in setting priorities, and in developing patient Plan of Care (POC). * Monitors cases to ensure documentation is in compliance with regulatory agencies and requirements of third-party payers. Ensures final audits/billing are completed timely and in compliance with Medicare regulations. * Coordinates communication between team members/attending physicians/caregivers to ensure the appropriateness of care and outcome planning. * Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. * Participates in sales and marketing initiatives. * Supervises all clinical employees assigned to a specific location. Responsible for the overall direction, coordination, and evaluation of the location. Carries out supervisory responsibilities in accordance with Company policies and procedures. * Handles necessary employee corrective action and discipline issues fairly and objectively, in consultation with the Human Resources Department and the Executive Director/Director of Operations. * Participates in the interviewing, hiring, training, and development of direct care clinicians. Evaluates their performance relative to job goals and requirements. Coaches staff and recommends in-service education programs, when needed. Ensures adherence to internal policies and standards. * Assesses staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed. * Analyzes situations, identifies problems, identifies and evaluates alternative courses of action through the utilization of Performance Improvement principles. * Responsible for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, for appropriateness of care, delivery, and documentation requirements. * Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance review and outcomes of care analysis to determine efficiency, the efficacy of case management system as well as any other systems and process. Competently performs patient care assignments and staff management activities. * Provides direct patient care on an infrequent basis and only in times of emergency. * Acts as Branch Director in his/her absence. * Interprets Company standards and Company policies and procedures to ensure compliance with external regulatory authorities and ensures that caregiver clinical documentation meets internal standards. * Participates in performance improvement activities, maintains ongoing clinical knowledge through internal and external training programs. Provides interpretation of knowledge and direction to staff. * Maintains relationships with referral/community sources. Participates in professional organizations and conducts care-related programs. * Performs other related duties as assigned or requested. Use your skills to make an impact Required Experience/Skills: * Graduate of an accredited School of Nursing. * Current state license as a Registered Nurse. * Proof of current CPR. * Valid driver's license, auto insurance and reliable transportation. * Two years as a Registered Nurse with at least one-year of management experience in a home care, hospice or equivalent environment. * Home health experience is required. * Management and people leadership experience, preferred. * OASIS experience, required. OASIS certification (HCS-O, COQS, and/or COS-C), preferred. * Homecare Homebase (HCHB) experience, preferred. * CMS PDGM billing knowledge and/or experience, preferred. Additional Information * Normal Hours of Operation: M-F / 8a-5p (CT) * On-Call Expectation: One week per month * Branch Size: 165 Census (4 STAR rating) * Annual Bonus Eligibility: Eligible for the annual incentive bonus which has pay-outs both quarterly and annually. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $77,200 - $106,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $77.2k-106.2k yearly 25d ago
  • Transition of Care Coach (RN)

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Chicago, IL

    **Illinois residency required Provides support for care transition activities. Facilitates transitional care processes and coordination for member discharge from hospital admission to all other settings. Strives to ensure that best possible services are available to members at time of hospital discharge, and focuses on goal to reduce member readmissions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Follows member throughout a 30 day program that starts at hospital admission and continues oversight through transitions from acute setting to all other settings, including nursing facility placement/private home, with the goal of reduced readmissions. • Ensures safe and appropriate transitions by collaborating with the hospital discharge planner, as well as collaborating with hospitalists, outpatient providers, facility staff, and family/support network. • Ensures member transitions to setting with adequate caregiving and functional support, as well as medical and medication oversight support. • Works with participating ancillary providers, public agencies or other service providers to make sure necessary services and equipment are in place for safe transition. • Conducts face-to-face visits of all members while in the hospital and, home visits high-risk members post-discharge as needed. • Coordinates care and reassesses member needs using the Coleman Care Transition model post-discharge. • Educates and supports member focusing on seven primary areas (Transition of Care Pillars): medication management, use of personal health record, follow-up care, signs and symptoms of worsening condition, nutrition, functional needs and or home and community-based services, and advance directives. • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. • Assesses for barriers to care, provides care coordination and assistance to member to address concerns. • Facilitates interdisciplinary care team meetings (ICT) and collaboration. • Provides consultation, recommendations and education as appropriate to non-behavioral health care managers. • 40-50% local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 2 years experience in health care, with at least 1 year of experience in hospital discharge planning, care management or behavioral health setting, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • Knowledge of or experience using the Care Transitions Intervention (CTI) or similar model. • Background in discharge planning and/or home health. • Demonstrated knowledge of community resources. • Proactive and detail-oriented. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to work independently, with minimal supervision and demonstrate self-motivation. • Responsive in all forms of communication, and ability to 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. • Excellent verbal and written communication skills. • Microsoft Office suite/other applicable software program(s) proficiency. Preferred Qualifications • Transitions of care sub-specialty certification and/or Certified Case Manager (CCM). • Hospital discharge planning or home health experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $27.73 - $54.06 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $30k-36k yearly est. 1d ago
  • Physical Therapist, Home Health

    Humana Inc. 4.8company rating

    Buffalo Grove, IL job

    Become a part of our caring community and help us put health first As a therapist at CenterWell Home Health, you'll play a vital role in helping patients regain strength, mobility and independence-all from the comfort of their homes. By delivering personalized care that focuses on rehabilitation and functional improvement, you'll empower individuals to overcome physical limitations, perform everyday activities with confidence and enjoy a better quality of life. As a Home Health Physical Therapist, you will: * Plan and administer prescribed skilled physical therapy treatment and training for patients suffering from various injuries, illnesses and functional disabilities to attain highest level of physical function. * Test/screen the patient's physical strengths to assist the physician in evaluating the patient's level of function and records findings to develop or pursue treatment programs and establish measurable training objectives. * Develop/implement a conditioning/rehabilitation program consistent with physician's Plan of Treatment and the overall goals of the patient/rehab team. Adjust treatment as needed to achieve maximum results. * Confer with physician and clinical team members to obtain additional patient information and assist in developing, implementing and revising the therapy treatment program and Plan of Treatment. * Provide Physical Therapy Assistants and Home Health Aide * staff with written instructions/care plan that reflects current plan of care as related to therapy, supervise/evaluate staffs' performance. Monitor the appropriate completion of documentation by physical therapy assistants and home health aides/personal care workers as part of the supervisory/leadership responsibility. * Accurately, promptly and thoroughly document patients' care observations, interventions and evaluations. Assure that interim (verbal) orders received from the physician and physical therapist are promptly and accurately documented, submitted for physician signature and implemented * Report patient's progress to the patient's physician, Clinical Manager, staff, patient and family. Submit evaluation, treatment plans, progress reports and discharge summary to the supervisor and care management staff. Use your skills to make an impact Required Experience/Skills: * Degree from an accredited Physical Therapy Program (approved by the APTA) * Minimum of one year physical therapy experience preferred * Current and unrestricted Physical Therapy license * Current CPR certification * Strong organizational and communication skills * A valid driver's license, auto insurance, and reliable transportation are required. Pay Range * $60.00 - $83.00 - pay per visit/unit * $93,900 - $129,300 per year base pay Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $93,900 - $129,300 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $93.9k-129.3k yearly 11d ago
  • Senior Manager, Medicare Sales - Chicago Metro

    Humana 4.8company rating

    Chicago, IL job

    **Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact your own income potential? If so, we are looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of Medicare Sales Field Agents who sell individual health plan products and educate beneficiaries on our services in a field setting. Our teams also sell Life, Annuity, Indemnity, Dental, Vision, Prescription plans, and more. Humana has an inclusive and diverse culture welcoming candidates with multilingual skill sets to service our consumers. **This role is** **field** **based, and you will be out and about in the field in the greater Chicago, IL** **area working with your team and meeting members face to face. You must reside in the Chicago, IL area or be willing to relocate to the area.** In this **field** position, you will; coach, mentor, educate, motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a solid understanding of the market they serve, how to resolve operational problems and provide creative solutions to increase sales while following CMS guidelines. This role also involves cultivating, maintaining, and building relationships with Humana's customers, both internal and external business partners, along with the community we serve through telephonic, virtual, and face-to-face interactions with individuals and groups. Other responsibilities include developing marketing budgets, and looking for branding opportunities. **Use your skills to make an impact** **Required Qualifications** + **Must reside in the Chicago, IL area or be willing to relocate** + **Active Health Insurance License** + 2+ years of Medicare sales or other related sales experience. + Must be able to travel up to 50% of the time + Ability to lead a team of sales associates and train them in successful sales techniques, educational presentation skills, utilizing technology tools as well as building relationships with communities and medical providers + Strong aptitude for technology with proficiency in MS Office products, various CRM platforms, and various iPhone app capabilities + Must be a strong leader, strong producer + Strong organizational, interpersonal, communication and presentation skills + Ability to adapt and overcome when necessary + Community Engagement/Grassroots experience in marketing Medicare plans in the community + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 25/25/10 limits **Preferred Qualifications** + Active Life Insurance License + Bachelor's Degree + Prior experience working in Medicare and the health solutions industry + Engaged with the community through service, organizations, activities and volunteerism + Project management background or certification a plus + Bilingual with the ability to speak, read and write without limitations or assistance **Humana Perks:** Full time associates enjoy: + Base salary with a competitive commission structure + Medical, Dental, Vision and a variety of other supplemental insurances + Paid time off (PTO) & Paid Holidays + 401(k) retirement savings plan + Tuition reimbursement and/or scholarships for qualifying dependent children. + And much more! **Social Security Task:** Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website. **Virtual Pre-Screen:** As part of our hiring process for this opportunity, we will be using exciting virtual pre-screen technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a virtual pre-screen, you will receive an email and text correspondence inviting you to participate in a HireVue interview. In this virtual pre-screen, you will receive a set of questions to answer. You should anticipate this virtual pre-screen to take about 10-15 minutes. \#MedicareSalesManager \#MedicareSalesReps Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $84,700 - $115,600 per year This job is eligible for a commission incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About Us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $84.7k-115.6k yearly Easy Apply 60d+ ago
  • Regional Provider Engagement Manager

    Centene Corporation 4.5company rating

    Chicago, IL job

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Job Description **_***Candidate must reside in either Atlanta, GA, Austin TX, Chicago IL or surrounding areas. Role will require both in office presence as well as travel throughout the region. Highly preferred that candidate possess experience in the following areas:_** + **Train on Provider Performance:** Equip market associates with the knowledge and tools to improve Medical Expense Ratio, Risk Adjustment accuracy, and overall financial outcomes. + **Guide Effective JOCs:** Teach teams how to plan, execute, and leverage Joint Operations Committee meetings to align providers and internal teams on performance goals. + **Develop Data Proficiency:** Train associates to interpret and act on financial and quality metrics (e.g., HEDIS, STARs) to drive targeted improvement strategies. + **Coach on Engagement Strategies:** Educate market teams on building strong provider relationships, optimizing incentive programs, and implementing value-based care models. **_***_** **Position Purpose:** The Regional Provider Engagement Manager will support provider performance and engagement efforts within a specific region that includes multiple local markets. This role will drive strategies and initiatives that support improvements in provider quality, cost-effectiveness, and clinical efficiency. + Provide hands-on PEOM support and guidance to include in person training, new hire following, process re-enforcement, new reports/initiatives roll out for assigned markets (All Levels) + Engage in Monthly/Quarterly PE Regional Leadership Check-ins + Lead new PE implementations within assigned regions (Templates, reporting, etc.) + Drive the execution of key strategic initiatives to support local markets, recommending opportunities for increasing business value. + Support the development of strategic operational plans and monitor implementation, including large-scale transformation projects. + Collaborate with health plan leaders to assist in facilitating system-wide implementations and ensure continuous improvement from pilot to full-scale implementation. + Drive key performance indicators (KPIs) and interpret data to improve provider performance. + Utilize data analysis to identify areas for service level improvements and develop specific actions based on findings. + Support local market relationships, providing high-touch and responsive servicing of critical providers through shared service resources. + Partner with health plans and enterprise Provider Experience team to monitor provider performance of risk arrangements for multiple product lines. + Assist in driving development of provider-related corporate initiatives, business plans, strategies, and goals. + Analyze industry trends and new technologies to maintain cutting-edge services and capitalize on emerging opportunities. + Analyze and interpret facts/results using research methods and techniques. + Prepare meaningful, actionable reports and provide routine communication of status via project plans, dashboards, presentations, or other tools as appropriate. + Escalate issues, as appropriate, to ensure timely resolution and on-time project delivery. + Enhance and leverage analytics, member demographics, and healthcare facility usage patterns to identify efficiency opportunities. + Collaborate with operational areas and appropriate vendors on initiatives supporting provider performance and financial efficiencies. + Perform special projects as assigned or directed. + Performs other duties as assigned. + Complies with all policies and standards. **Education/Experience:** Bachelor's Degree health care administration, business, or related field or equivalent experience required **Master's Degree preferred** 5+ years within provider management or healthcare strategy required In-depth knowledge of provider engagement, network management, and performance improvement methodologies required. Demonstrated track record of successfully leading cross-functional provider engagement teams and driving results in a dynamic environment required. Pay Range: $86,000.00 - $154,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $86k-154.7k yearly 60d+ ago
  • Community Resource Coordinator III

    Centene Corporation 4.5company rating

    North Chicago, IL job

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **New Opportunity in Illinois!** **Centene is seeking a Community Resource Coordinator III to join our Illinois team!** **In this role, you'll support members and communities through home visits, community events, and resource connections, making a direct impact on health outcomes. We're looking for candidates with experience in community or social services who are passionate about helping others access the support they need.** **Role Details** + **80% field-based position** + **Coverage area is Lake County** + **Collaborate with members, providers, and community partners to connect individuals with vital resources** **If you have a background in community engagement, social services, or care coordination and enjoy working directly with people in the field, we'd love to hear from you!** **Position Purpose:** Works with care management team on community resource connection activities including connecting members to community resources to support their care management journey and provide necessary care resources in a cost-effective manner. Provides members with known community resources and works with the care team to identify member community support and provide health education as appropriate. + Provides ongoing support to members to connect them to known community and care resources in a cost-effective manner + Supports the coordination of community outreach resources available to members and promotes awareness of care/services + Serves as experienced support for members on community and care resource inquiries and opportunities available to members + Utilizes in-depth knowledge of community resource connection activities and resource opportunities + Supports member related correspondence and educational materials to assist in the facilitation of a successful community connection + Works with care management team on escalating community resource requests and inquiries to management and identifying member community support + Documents and maintains community resources to ensure standards of practice and policies are in accordance with health plan requirements + Provides support to the clinical team of nurses and social workers with activities including, but not limited to outreach, community education, evidence-based guidance, and member support + Conduct non-clinical general health assessments in order to refer members to appropriate services, resolve concerns on member's behalf, and gather information for medical providers and staff working within the organization + Conduct non-medical assessments such as home safety, assessment of the community/environment resources, transportation, employment, and others to be able to refer to appropriate services, resolve concerns on member's behalf, and gather information for medical providers in staff working within our organization + Conduct telephonic and/or in-person outreach to locate individuals and families in the community who are hard to reach + May make visits to individual homes and/or community organizations + Working Knowledge of Social Determinants of Health (SDOH) barriers + Performs other duties as assigned + Complies with all policies and standards **Education/Experience:** Requires a High School diploma or GED Requires 2 - 4 years of related experience Pay Range: $20.00 - $34.03 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $20-34 hourly 40d ago
  • Community Connector (Southwest State counties, IL)

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Naperville, IL

    JOB DESCRIPTION Job SummaryProvides support for community-based member advocacy activities. Serves as a local member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing health care needs. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Engages with members as an advocate and resource to support management of health care needs. - Collaborates with and supports the health care services team by providing non-clinical paraprofessional duties in the field to include meeting with members in their homes, nursing homes, shelters, provider offices, etc. - Empowers members by helping them navigate and maximize their health plan benefits. Assistance may include: scheduling appointments with providers, arranging transportation for health care visits, getting prescriptions filled and following-up with members on missed appointments. - Assists members in accessing social services such as community-based resources for housing, food, employment, etc. - Provides outreach to locate and/or provide support for disconnected members with special needs. - Conducts research with available data to locate members that Molina has been unable to contact (e.g., reviewing internal databases, contacting member providers or caregivers or travel to last known address or community resource locations such as homeless shelters, etc.) - Participates in ongoing or project-based activities that may require extensive member outreach (telephonic and/or face-to-face). - Guides members to maintain Medicaid eligibility and with other financial resources as appropriate. - 50-80% local travel may be required (based upon state/contractual requirements). Required Qualifications- At least 1 year of health care experience, preferably working with underserved or special needs populations with varied health, economic and educational circumstances, or equivalent combination of relevant education and experience. - Community Health Worker (CHW) certification may be required for certain states (dependent upon contractual requirements). - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. - Ability to multi-task applications while speaking with members. - Excellent customer service skills. - Organizational and time-management skills. - Ability and willingness to learn other lines of business, programs and relevant software systems/applications. - Excellent verbal and written communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Community Health Worker (CHW) certification (for states other than Ohio, Florida and California, where it is required). - Certified Medical Assistant (CMA). - Bilingual in Spanish, Russian, Yuri, Arabic, or ASL. - Familiarity with health care systems. - Knowledge of community-specific culture. - Experience with/or knowledge of health care systems, community resources, social services, and/or health education. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V \#PJHPO3 Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $21.2-38.4 hourly 59d ago
  • Director, Community Relations

    Centene Corporation 4.5company rating

    Burr Ridge, IL job

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. *** Preference of a candidate that lives in Cook or collar counties in Illinois and be willing to travel 50% within the state*** **Position Purpose:** Oversee and manage the community relations and marketing functions of the health plan in accordance with government and contractual guidelines and the mission, philosophy and objectives of the Corporation + Develop, execute, and oversee community outreach strategy for the health plan. + Oversee and coordinate the marketing and community relations staff's work flow and communicate established performance standards. + Provide oversight for the Health Happens Here grant team, including refining process and strategy. + Participate in the development of annual health plan objectives and strategic planning activities to contribute to the growth and profitability of the health plan and corporation. + Develop and ensure compliance with departmental objectives that are consistent with the health plan and corporate objectives. + Participate in health plan, corporate, community and interagency boards, task forces and meetings as necessary. + Develop departmental annual budget and operate the department within the approved budget. + Review and analyze reports, records and directives, and confer with staff to obtain data required for planning work function activities, such as new projects, status of work in progress, and problems encountered. + Travel 50% within the state of IL **Education/Experience:** Bachelor's Degree in Public Relations, Marketing, Health Administration, Social Services, related field or equivalent experience. or equivalent experience. 7+ years of public affairs, community relations, provider relations/network or public policy experience, preferably in a managed care, insurance, healthcare environment. Experience working with ad agencies, community based organizations, public relations firms or member advocacy. **License/Certification:** Current state driver's license.Pay Range: $110,900.00 - $205,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $73k-90k yearly est. 34d ago
  • Care Coordinator, RN Field Based

    Humana 4.8company rating

    Hammond, IN job

    **Become a part of our caring community and help us put health first** Humana Healthy Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging (PathWays). The program was designed to help more Hoosiers who choose to age at home, do so, and to achieve better access to services, and better health and quality outcomes. You will be part of a caring community at Humana. When you meet us, you can tell we started as a hometown company. We are proud of our Louisville roots and, as we have grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are-whether you are working from home, from the field, from our offices, or from somewhere in between-you will feel welcome here. We are a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone's voice is heard and respected. Community is a verb here. It is up to each of us to care for it and maintain it. Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve. * Health Insurance begins on day one! * 23 days of vacation with pay per year * Aggressive 401K program matching 125% of 6% after year one! Are you caring, Curious and Committed? If so, apply today! **Position Responsibilities:** The Care Coordinator 2 employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues. Identifies and resolves barriers that hinder effective care. + Facilitate the development of a longitudinal and trusting relationship with each member toward improved quality, continuity, and coordination of care. + Responsible for the coordination of all the member's needed medical and non-medical services, including functional, social, and environmental services. + Works collaboratively with the Service Coordinator, Transition Coordinator, and other care team staff to address the member's identified needs + Coordinates with all Medicare payers, Medicare Advantage plans, and Medicare providers as appropriate to coordinate the care and benefits of members who are also eligible for Medicare. + Primary point of contact for the Interdisciplinary Care Team (ICT) and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member's needs are met. **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the state of Indiana without restrictions + At least one (2) years of clinical experience as a nurse in providing case management or similar health care services (internal note: could be LPN experience if relevant) + Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook. + Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders. + Proven ability of critical thinking, organization, written and verbal communication and problem- solving skills. + Ability to manage multiple or competing priorities in a fast-paced environment. + Ability to use a variety of electronic information applications/software programs including electronic medical records. + Live/Reside in Indiana **Preferred Qualifications** + Bilingual (English/Spanish) or (English/Burmese) + Prior nursing home diversion, long-term care, disease management, or case management experience + Prior management of Home and Community Based Services waivers (HCBS dual roles only) + Prior experience with Medicare & Medicaid recipients + Experience working with a geriatric population + Experience with health promotion, coaching and wellness + Knowledge of community health and social service agencies and additional community resources **Additional Information** **About Humana** **Your growth is what drives Humana forward.** + When you get here, the journey is just beginning. Our leaders are committed to understanding what you need to grow. Because we do not grow without you + This is a place where our nurses influence the C-suite. + Where software engineers change lives. + Where every associate can build a professional path where they learn and thrive. + Through our commitments to wellbeing and work-life balance, we support each associate's personal health, purpose, work style, sense of belonging, and security. + Because finding new ways to put health first-for our members and patients and our associates alike-is what we do. **Additional Requirements/Adherence** **Workstyle:** Combination remote work at home and onsite member visits **Location:** Must reside in Indiana **Hours:** Must be able to work a 40-hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs. **Travel:** Must be willing to commute about 70% to meet with members. **On Call** **-** Telephonic on call for an occasional night and/or weekend may be required. **Work at Home Guidance** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if approved by leadership. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **Driver's License, Transportation, Insurance** This role is a part of Humana's Driver Safety program and therefore requires and individual to have: + Valid state driver's license + Proof of personal vehicle liability insurance with at least $100,000/$300,000/$100,000 limits + Access to a reliable vehicle **Tuberculosis (TB) screening program** + This role is considered patient facing and is part of Humana at Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. **Interview Format** As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. You will be able to respond to the recruiters preferred response method via text, video, or voice technologies. If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication is not missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $71.1k-97.8k yearly 32d ago
  • Material Handler - First Shift- Manteno, IL

    McKesson 4.6company rating

    Manteno, IL job

    McKesson is seeking dynamic & engaging individuals to fill multiple Material Handler roles in our distribution center located in Manteno, IL. This will be a contract role with a potential opportunity to expand into a permanent position based on business needs and performance. If we gained your interest in learning more about McKesson, we encourage you to apply by clicking I'M INTERESTED below. If you are passionate about inspiring, motivating, and assisting our team, this opportunity could further enhance our journey and we want to hear from you. Day to day we will be servicing our customers in receiving the medical supplies needed to improve their quality of life. From day one, you will be able to create a positive culture for the entire DC, that reinforces our McKesson values. Our Current Hiring Need is Material Handlers First Shift Pay Rate: $21.99/hr. Job Description Performing the physical tasks involved in the shipping, receiving, storing, and distributing medical products Pulls and fills orders. Working with RF Scanning equipment to maintain records of merchandise shipped, as well as examine, stock, and distribute materials in inventory and on manufacturing lines. Preparing goods for final shipment. Will use power equipment including, but not limited to forklift, hand tools, and other devices operated in a warehouse environment while maintaining the highest level of productivity and accuracy. Standing and engaging in repetitive movement throughout the entire shift. Extensive walking and mandatory overtime as needed is required. Passion around working for a leading healthcare distribution company focused on distributing pharmaceuticals to more than 40,000 customers ranging from retail chains, independent retail pharmacies, hospitals, health systems, and other healthcare facilities. If you like the sound of these job tasks and perks, then starting your career as a Material Handler is right for you! Keep Your Edge - Stay mentally sharp throughout your shift picking, checking, or packing orders as you strategically get the job done. Stay Fit -Get your workout in as you bend, twist, lift up to 50lbs, and walk extensive miles per shift. Take advantage of possible on the job training to operate power equipment and get certified! Our Distribution Centers is climate controlled and utilizes state of the art systems & equipment. Stay comfortable while working in a fast-paced team-oriented environment! Qualifications Qualifications 0-1+ year experience. Prefer experience working with Warehouse Equipment (Power Industrial Equipment, Forklift, Cherry Picker, Pallet Jack, etc.). The ability to read, write, speak and understand English in order to work independently and to communicate about, understand and follow job and safety-related instructions and rules. Critical Skills: Working knowledge of Material Handling issues. Work experience in a fast-paced, distribution or warehouse environment or stock room strongly preferred; picking/packing, sorting, loading/unloading, scanning, quality inspection or various other warehouse functions. The ability to work the hours listed above, in addition to overtime. * Overtime in most Distribution Centers is mandatory and typically occurs M-W due to our real-time commitments to our customers. Strong reading, addition and subtraction skills needed to manage order specific documentation. Additional Information All your information will be kept confidential according to EEO guidelines.
    $22 hourly 2h ago
  • MCO Government Contracts Sr. Specialist (Illinois Experience Needed)

    Molina Healthcare Inc. 4.4company rating

    Molina Healthcare Inc. job in Chicago, IL

    Molina Healthcare is hiring a Sr Specialist in our Government Contracts department. This role is remote with a high preference for candidates who reside in Illinois. The Sr Specialist in our Government Contracts will be responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations. You will also Intake state correspondence for Government Contract SharePoint logs, assign internally, and track to completion. Provide timely responses to external regulators on all requests. Attend and take notes for HFS meetings. Track Member/Provider complaints along with the impact on customer experience with Molina to improve on all levels. Highly qualified candidates will have the following experience- * Live in Illinois and are familiar with Managed Care in Illinois and how HHF operates. * Background/experience in business analytics, deadline tracking, previous experience researching and interpreting contract language is also a plus. * Great at building relationships and working across departments, able to articulate GC expectations for deliverables and interpret regulator instructions. * Comfortable speaking with all levels of leadership. KNOWLEDGE/SKILLS/ABILITIES * Responsible for coordinating, conducting and/or responding to research requests pertaining to government healthcare programs; preparing and submitting regulatory reports for filings; reviewing Plan submissions for quality, accuracy, and timeliness; and ensuring Plan meets contractual and regulatory requirements. * Reviews Provider Agreement, EOC/ Member Handbook, Provider Directory, marketing materials, and other contract reporting deliverables for compliance with contractual and regulatory requirements prior to submission. * Assesses information received from government contracting agencies and regulators and disseminates to impacted Plan staff. * Participates in meetings related to Molina government run programs with State agencies and Molina Corporate departments and disseminates relevant information to staff and management. * Oversees/maintains the department's documentation and archive system, ensuring submitted reports are archived for historical and audit purposes. Ensures system is updated and complete. JOB QUALIFICATIONS Required Education: High School diploma or equivalent Preferred Education: Bachelor's Degree in Business Administration, Healthcare, or related field. Required Experience * 3 years' experience in a managed care environment. * Experience demonstrates strong: communication and presentation skills; analytical/reasoning ability; detail orientation; organizational and interpersonal skills. * Proficient in compiling data, creating reports, and presenting information, using Crystal Reports (or similar reporting tools), SQL query, MS Access, and MS Excel. 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: $47,660 - $88,511.46 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $47.7k-88.5k yearly 14d ago
  • Care Manager, LTSS (Must Reside in Southern Cook County)

    Molina Healthcare 4.4company rating

    Molina Healthcare job in North Chicago, IL

    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. 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. • 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications • 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. •Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • 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. • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). Preferred Qualifications • Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. • Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $25.2 - $49.15 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $31k-37k yearly est. 1d ago
  • Care Manager, LTSS

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Aurora, IL

    ****Must be a current resident of Illinois near one of the cities listed on this job posting.** 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. 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. - 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications - 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. -Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. - In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. - 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. - Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. - In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). Preferred Qualifications - Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. - Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V \#PJHS3 Pay Range: $25.2 - $49.15 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $25.2-49.2 hourly 60d+ ago

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