Back to feed

Waiver Support Specialist (Remote in TX)

Remote Full-time Live

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 • Provide non-clinical operational support for Waiver coordination. • Facilitate communication between Waiver coordinators and the state Program Support Unit. • Responsible for receiving the initial State referrals for waiver services and working with the Long-Term Services & Supports (LTSS) Coordinator to schedule the initial assessment. • Monitor status for initial assessment, reassessment, and transition assessments for members. • Interface with the State agency that determines eligibility and the LTSS Coordinator to process and obtain approval of Waiver services. • Monitors transition process of Nursing Facility members in custodial beds to return to the community for 'Money Follows the Person' program. • Initiates referral for Medicare and Waiver process if member is not already Medicare or waiver established. • Tracks referrals and case documents via designated state systems. • Track activities occurring within the transitional, assessment and authorization processes, using internal systems and designated state systems, and report results to coordinators, supervisors, and the State agency. • Ensure Medicaid and Waiver eligibility have been requested and received from state partners before transition or services are initiated. • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). • Attend internal meetings and regularly scheduled calls as assigned. • Other administrative functions as needed. JOB QUALIFICATIONS Required Education HS Diploma or GED Required Experience • 1-3 years' experience in an administrative support role in healthcare. • Experience demonstrating ability to handle multiple work tasks, prioritize tasks, and excellent problem solving. • Experience demonstrating strong communication skills. Preferred Education Associate degree Preferred Experience • 3+ years' experience in an administrative support role in healthcare, Medical Assistant preferred. • 2 years Long Term Care experience preferred and/or Managed Care experience. 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 Apply Job!

On the same wavelength

Customer Service Representative at Aetna – Part-Time

Remote Full-time

Sr. SAP S/4 Hana Professional (SAP S/4 SD, OTB; SAP BRIM) - Work From Home

Remote Full-time

Pop Health Administrator - Remote | WFH

Remote Full-time

Contract Graphic Designer

Remote Full-time

Disney Data Entry Jobs (Remote-Career) – Work From Home Job

Remote Full-time

Insurance professional

Remote Full-time

American Express Data Entry Work From Home Opportunities - $/H

Remote Full-time

Internet Rater | Earn Money Online Today

Remote Full-time

Customer service sales

Remote Full-time

Welder/Fabricator

Remote Full-time

Director, Visual Arts & Artist Programs

Remote Full-time

Virtual Research & Scheduling Assistant-Entry Level

Remote Full-time

Experienced Customer Chat Representative Entry-Level Role - Work from Home Opportunity with arenaflex

Remote Full-time

Sr Project Manager

Remote Full-time

Experienced Medical Director for Aetna One Advocacy - Transforming Healthcare through Clinical Expertise and Business Leadership

Remote Full-time

Senior Customer Success Manager

Remote Full-time

Experienced Customer Service Representative – Back Office Role for Life and Pension Queries with Hybrid Remote Work Arrangement

Remote Full-time

Specialized Tax Credits and Government Incentives (SR&ED), Senior Associate

Remote Full-time

Test Automation Engineer III (Selenium and Python) - Pune/Banaglore/Delhi

Remote Full-time

Experienced Operations Research Developer - Remote Career Opportunity with Southwest Airlines

Remote Full-time