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ATTENTION JOB SEEKERS AND MOLINA APPLICANTS: FRAUD ALERT

Be aware that third parties posing as Molina Healthcare may be soliciting money from job seekers and extending offers to candidates who have not interviewed. Molina does not engage in these type of practices. If you have received an offer and have not been engaging with Molina Healthcare in an interview process, reach out to erc@molinahealthcare.com to validate the legitimacy of your offer. Please note that Molina has reported this activity to the appropriate law enforcement agencies for further investigation. If you feel you’ve been victimized, please report it to local law enforcement.

Care Coordinator (HEDIS Measures) SE WI Preferred Remote

Molina Healthcare Milwaukee, Wisconsin; Madison, Wisconsin; Port Washington, Wisconsin; West Bend, Wisconsin; Racine, Wisconsin Job ID 2029015
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Molina Healthcare is hiring for a Care Coordinator.  This role is remote with a preference for location being in/near southeastern Wisconsin.

The (non-clinical) Care Coordinator works with members, providers and multidisciplinary team members, focusing on specific HEDIS measures- Asthma, Diabetes and Hypertension. This role will assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.

Highly Qualified Applicants will have the following qualifications-

  • A passion for providing the education needed to members to help manage and improve chronic health conditions.
  • Background or experience in social work, community health, Community Health Worker (CHW), public health, health education, Certified Health Education Specialist (CHES), or the like.
  • Above average computers skills (able to work proficiently in MS Outlook, Word, Excel)

Job Duties

  • Performs care coordination activities in collaboration with health care providers, other HCS staff, involved medical case managers, case management processors, community-based organizations (CBOs), and other providers as required to provide timely and accurate service authorizations and integrated care.
  • Assist members with social determinant of health needs, challenges in accessing health & community resources or other needs that fragment care and lead to poor health outcomes. 
  • Documents all findings, contacts, and interventions in the electronic care management system.
  • Collaborates with state agencies, healthcare professionals and community support systems promote integrated care.
  • Expected to meet daily production standards in terms of member outreach.
  • Provide face-to-face care coordination activities in the communities where members reside.
  • Assesses for barriers to care, provides care coordination and assistance to member to address psychosocial, financial, and medical obstacle concerns. 
  • Accurately interprets specific state and/or federal benefits, contracts as well as additional business requirements and converting these terms to configuration parameters.
  • Coordinating the authorization of needed services such as timely approval of durable medical equipment, pharmacy, and medical supplies.
  • Ensuring access to Medically Necessary physical health or Behavioral Health through assisting with appointments and transportation services.
  • Provides coaching/information for available health services or health education
  • #LI-TR1

Job Qualifications

Required Education:

  • Bachelor’s Degree in a health care related field; however, relevant experience will be considered in lieu of degree.

Required Experience: 

  • Para-professional whose background is anchored in social work or community health systems – per contract can be non-licensed.
  • Min. 1 year clinical experience

Preferred Qualifications:

  • Experience in social services, medical terminology
  • Experience in managed care environment; including knowledge or applicable state and federal regulations and standards.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Key Words: HEDIS, CHES, Certified Health Education Specialist, WI, Public Health, Health Education, Communication, Instructional Skills, Training, Member Training, Teacher, Training, Health Education, CHW, Community Health Worker, Social Work, Case Management, Non-Clinical Case Management, Case Care, Case Specialist

Pay Range: $16.4 - $31.97 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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.

Job Type: Full Time Posting Date: 12/07/2024

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