Specialist, Waiver

Job Summary

Provides support for member waiver coordination activities. Contributes to interdisciplinary team efforts supporting provision of integrated delivery of care across the continuum, and overarching strategy to provide quality and cost-effective member care.

• Provides non‑clinical operational support for member waiver coordination processes.
• Facilitates communication between waiver coordination and the state program support unit.
• Receives initial state referrals for waiver services and works with long‑term services and supports (LTSS) to schedule initial assessment.
• Monitors status of initial member assessments, reassessments and transition assessments.
• Interfaces with the state agency that determines eligibility for LTSS, to process and obtain approval of waiver services.
• Monitors transition process of nursing facility members in custodial beds to return to the community.
• Initiates referrals for Medicare and waiver process if the member is not already Medicare or waiver established.
• Tracks referrals and case documents via designated state systems.
• Tracks activities occurring within the transitional, assessment and authorization processes—using internal systems and designated state systems—and reports results accordingly.
• Ensures Medicaid and waiver eligibility has been requested and received from state partners before transition/services are initiated.
• Maintains confidentiality and complies with Health Insurance Portability and Accountability Act (HIPAA).
• Attends internal meetings and regularly scheduled calls as assigned.

• At least one year of experience in an administrative support role in a health‑care setting, or equivalent combination of relevant education and experience.
• Ability to manage multiple work tasks and prioritize.
• Excellent problem‑solving skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs.

• Certified Medical Assistant (CMA).
• Long‑term care and/or managed care experience.

If you are a current Molina employee interested in this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package.

Pay Range: $14.90 – $29.06 / HOURLY

Actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level.

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.