Esther Beltran Castro-Rico

1. Identifying members who would benefit from CM services. 2. Performing assessments to evaluate appropriateness of potential candidates, to include out-of-home placement when necessary 3. Planning, organizing & coordinating all necessary services based on multidisciplinary team approach for high risk & medical cases. 4. Development & implementation of an individualized treatment care plan to establish long-term & short-term goals to assist members to reach their optimal health status. 5. Coordinating timely care & services in the most appropriate settings. 6. Facilitating collaborative communication between Molina, the member, PCP, Specialists, member’s support resources, community resources, etc 7. Assisting members to receive efficient, cost effective medically necessary health care from contracted &/or out-of-network providers. 8. Authorizes necessary & appropriate services per approved UM review criteria & guidelines. 9. Consults with a Medical Director to evaluate & determine extensions of extra-contractual benefit reimbursement for alternative methods of care which are appropriate/cost effective. 10. Working collaboratively with CA Children Services, Early Start Program, Regional Centers & Mental Health Departments, community resources & physician or ancillary providers to ensure services to members across the health care continuum. 11. Assisting members with transportation programs that support our member’s access to health care services. 12. Supporting the Perinatal Case Management Program in collaboration with Molina Healthcare’s Motherhood Matters Program in conduction of assessments for each trimester & follow-up during the postpartum period. 13. Assisting providers / members in gaining access to needed medical, social,& educational services available to Early Periodic Screening Diagnosis & Treatment (EPSDT) eligible members. 14. Monitoring/evaluating services, outcomes & adjusting the care plan as necessary. 15. Documentation & tracking of cases.

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