See all roles

Waiver Support Specialist (Remote in TX)

Work from home Full-time role Hiring

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!

You might like

Customer Service Representative at Aetna – Part-Time

Work from home Full-time role

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

Work from home Full-time role

Pop Health Administrator - Remote | WFH

Work from home Full-time role

Contract Graphic Designer

Work from home Full-time role

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

Work from home Full-time role

Insurance professional

Work from home Full-time role

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

Work from home Full-time role

Internet Rater | Earn Money Online Today

Work from home Full-time role

Customer service sales

Work from home Full-time role

Welder/Fabricator

Work from home Full-time role

Conduct Assurance Manager

Work from home Full-time role

Talent Acquisition Recruiter

Work from home Full-time role

Adjunct Faculty, Geographical Information Science (GIS)

Work from home Full-time role

Freelance Writer - Gaming, Entertainment & Viral News (North America)

Work from home Full-time role

Remote Support Staff Professional – Administrative Excellence & Healthcare Innovation at Aetna

Work from home Full-time role

Walgreens Near Me Careers, Wfh Data Entry Jobs

Work from home Full-time role

Remote Data Entry Specialist – Entry-Level Position with arenaflex – Flexible Work‑From‑Home Opportunity

Work from home Full-time role

Senior Program Manager, Customer Service Contact Reduction, Self-Service and Automation, Customer Engagement Technologies at arenaflex

Work from home Full-time role

RCIS Crop Claims Field Adjuster I (North Dakota) (Virtual, ND, US)

Work from home Full-time role

Experienced Customer Service Representative for Fully Remote Position – Delivering Exceptional Support and Ensuring Customer Satisfaction at arenaflex

Work from home Full-time role