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Job Description

Job Summary

The Lead Specialist, Functional Screen - MCW manages all facets of the Long-Term Care Functional Screen (LTCFS). The Lead Screener ensures accurate functional eligibility determination and rate setting of program members through continuous quality improvement and quality assurance monitoring of Certified Functional Screeners.

Job Duties

+ Monitor quality and accuracy of Long-Term Care Functional Screens (enrollment, annual, rescreen, edit) completed by the Certified Functional Screeners in IDT model screening regions.

+ Track and ensure adherence to LTCFS timeframes.

+ Review and track Level of Care and condition changes for members, including follow-up consultation with IDT staff and MCO Enrollment/Eligibility/Fiscal staff as appropriate.

+ Develop, implement, and monitor LTCFS training for new staff, existing staff, Care Management Oversight Division, and the mandatory Department of Health Services (DHS) Adult Screener Continuing Skills Testing.

+ Support staff in multiple geographic service regions

+ Inform Certified Screeners of changes to LTCFS format and instructions. Coordinate and facilitate annual MetaStar and WI Department of Health Service Audits as well as ongoing Quality Assurance auditing to meet DHS contract requirements.

+ Implement corrective action plans, as required, to address screener certification or qualification concerns.

+ Conduct rescreens for members as needed for Level of Care determination or for training purposes, allowing new/existing screeners to shadow a Lead Screener. Makes occasional home visits for this purpose.

+ Respond to expedited requests by senior leadership, Care Management Oversight Division, MetaStar, DHS to review, audit, and report back on member screens.

+ Other duties as assigned.

Job Qualifications

Required Education:

Bachelor’s degree from an accredited college or university in health & human services, or related field required.

Required Experience, Knowledge, Skills, and Abilities:

+ LTCFS Certification required, with 1-3 years LTCFS, Family Care or other Long-Term Care program.

+ Leadership skills to maximize staff professional development, meet performance quotas, and balance team with independent responsibilities.

+ Experience with data management, project coordination, and training required.

+ Ability to explain and teach complex and detailed material in group and individual settings.

Required Licensure or Certification:

+ LTCFS Certification required, with 1-3 years LTCFS, Family Care or other Long-Term Care program.

+ Valid state of Wisconsin driver’s license, reliable transportation, and insurance are required at the time of filing application and must be maintained throughout employment.

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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Pay Range: $21.82 - $42.55 / HOURLY

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