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
- Serves as a community based member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing their healthcare needs.
- Empowers members by helping them navigate and maximize their health plan benefits.
- Assistance may include: scheduling appointments with providers; arranging transportation for healthcare 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 Molina Healthcare 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 (telephonically).
- Guides members to maintain Medicaid eligibility and with other financial resources as appropriate.
JOB QUALIFICATIONS
REQUIRED EDUCATION:
HS Diploma/GED
REQUIRED EXPERIENCE:
- Minimum 1 year experience working with underserved or special needs populations, with varied health, economic and educational circumstances.
- Managed Care exposure and knowledge of community resources; knowledge of HIPAA and confidentiality rules
- Minimum 2 year experience working with members with behavioral health issues, psychiatric disorders, drug and/or alcohol dependence, and physical illnesses.
REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:
• Must have valid driver’s license
PREFERRED EDUCATION:
Associate's Degree in a health care related field (e.g., nutrition, counseling, social work).
PREFERRED EXPERIENCE:
- Bilingual based on community need.
- Familiarity with healthcare systems a plus.
- Knowledge of community-specific culture.
- Experience with or knowledge of health care basics, community resources, social services, and/or health education.
- Call Center Experience
- Experience in psychiatric unit or facility a plus but not necessary.
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:
• Active and unrestricted Medical Assistant Certification
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.
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