**Must reside in New Mexico

Job Description

Job Summary
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to 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. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. 

Knowledge/Skills/Abilities
• Provides oversight of Plan's Long Term Services & Supports (LTSS) service delivery 
• Acts as Subject Matter Expert for case manager and service coordination staff 
• Ensures compliance with the State-specific Memorandum of Understanding (MOU)/Contract Scope of Work 
• Assists the Director with state-specific reporting requirements 
• Works with Director to operationalize the Plan's LTSS responsibilities and oversight 
• Participates in County advisory groups and liaises with consumer advocacy organizations, members, caregivers (as appropriate) and other community-based organizations to ensure program integrity and identify areas for development. 
• Develops and facilitates training on LTSS and Managed Care for Plan, community-based agencies, delegated entities, and other partners as needed. 
• Works collaboratively with Area Agencies on Aging (AAA) and State or County agencies to provide oversight to ensure member needs are being met. 
• Oversees the assessment and integrated service plan development process and monitors adherence to regulatory timelines. 
• Develops and maintains relevant processes, procedures and reference material (QRGs) necessary to guide the service/care coordination staff in providing timely assessments, service planning, care coordination and appropriate referrals. 
• Promotes multidisciplinary collaboration, provider outreach, collaboration with County social workers or other assigned case managers, and engagement of family and caregivers to enhance the continuity of care for Molina members. Oversees Interdisciplinary Care Team meetings. 
• Actively participates in the recruitment and hiring of LTSS Supervisors and Service/Care Coordinators with appropriate skills and experience. 
•25% local travel required.. 

Job Qualifications

Required Education
Bachelor's Degree in Public Health, Public Policy, Health Administration, Gerontology, Social Work, or related field. 

Required Experience
• Min. 3-5 years experience in health care delivery network. 
• Proven experience with and knowledge of In-Home Supportive Services (IHSS). 
• Knowledge of Disability & Senior Access issues and proven experience with disability and senior advocates. 

Required License, Certification, Association
N/A 

Preferred Education
Master's Degree in Public Health, Public Policy Health Administration, Gerontology, Social Work or related field. 

Preferred Experience
3-5 years experience working with IHSS, Public Authorities (PA's), and unions (e.g., SEIU/UDW). 

Minimum of 3 years of LTSS Utilization Management experience, including Self-Directed Community Benefits (SDCB), Agency-Based Community-Based Services, Nursing Facility, and EPSDT.

1–2 years of supervisory or managerial experience specifically within LTSS UM.

Strong knowledge of New Mexico Medicaid regulations and LTSS program criteria

Preferred License, Certification, Association
(RN) Registered Nurse, or (LPN/ LVN) Vocational Nurse

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: $73,102 - $142,549 / 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.