Field Care Manager, LTSS (RN)

JOB DESCRIPTION

Opportunity for a Texas licensed RN to hitch Molina as a Field Care Manager to work with our Medicaid members within the service supply space round Fannin and Grayson Counties. You will full assessments wanted for figuring out the varieties of companies the waiver members are eligible to obtain. Preference will probably be given to these candidates with earlier expertise working with the Medicaid inhabitants inside a Managed Care Organization (MCO). Mileage is reimbursed as a part of our advantages package deal. Hours are Monday – Friday, 8 AM – 5 PM CST.

Solid expertise with Microsoft Office Suite is critical, particularly with Outlook, Excel, and Teams in addition to being assured in shifting between totally different packages to finish the required varieties and documentation. 

 Job Summary

Provides help for care administration/care coordination long-term companies and helps particular actions and collaborates with multidisciplinary staff coordinating built-in supply of member care throughout the continuum for members with high-need potential. Strives to make sure member progress towards desired outcomes and contributes to overarching technique to supply high quality and cost-effective member care.

Essential Job Duties

• Completes complete member assessments inside regulated timelines, together with in-person house visits as required.
• Facilitates complete waiver enrollment and disenrollment processes.
• Develops and implements care plans, together with a waiver service plan in collaboration with members, caregivers, physicians and/or different applicable well being care professionals and member help community to deal with the member wants and targets.
• Performs ongoing monitoring of care plan to guage effectiveness, doc interventions and aim achievement, and recommend modifications accordingly.
• Promotes integration of companies for members together with behavioral well being care and long-term companies and helps (LTSS) and residential and neighborhood assets to boost continuity of care.
• Assesses for medical necessity and authorizes all applicable waiver companies.
• Evaluates coated advantages and advises appropriately concerning funding sources.
• Facilitates interdisciplinary care staff (ICT) conferences for approval or denial of companies and casual ICT collaboration.
• Uses motivational interviewing and Molina scientific guideposts to coach, help and inspire change throughout member contacts.
• Assesses for limitations to care and supplies care coordination and help to members to deal with psycho/social, monetary, and medical obstacles considerations.
• Identifies crucial incidents and develops prevention plans to guarantee member well being and welfare.
• May present session, assets and suggestions to friends as wanted.
• Care supervisor RNs could also be assigned advanced member instances and medicine regimens.
• Care supervisor RNs might conduct remedy reconciliation as wanted.
• 25-40% estimated native journey could also be required (primarily based upon state/contractual necessities).

Required Qualifications

• At least 2 years expertise in well being care, together with not less than 1 12 months expertise in care administration, managed care, and/or expertise in a medical or behavioral well being setting, and not less than 1 12 months of expertise working with individuals with disabilities, persistent situations, substance abuse issues, and long-term companies and helps (LTSS), or equal mixture of related schooling and expertise.
• Registered Nurse (RN). License should be lively and unrestricted in state of follow.
• Valid and unrestricted driver’s license, dependable transportation, and satisfactory auto insurance coverage for job associated journey necessities, except in any other case required by regulation.
• Ability to function proactively and display detail-oriented work.
• Demonstrated information of neighborhood assets.
• Ability to work inside a wide range of settings and modify fashion as wanted – working with numerous populations and numerous personalities and private conditions.
• Ability to work independently, with minimal supervision and display self-motivation.
• Responsiveness in all types of communication, and skill to stay calm in high-pressure conditions.
• Ability to develop and keep skilled relationships.
• Excellent time-management and prioritization expertise, and skill to deal with a number of initiatives concurrently and adapt to alter.
• Excellent problem-solving and critical-thinking expertise.
• Strong verbal and written communication expertise.
• Microsoft Office suite/relevant software program program(s) proficiency.
• In some states, will need to have not less than one 12 months of expertise working immediately with people with substance use issues.

Preferred Qualifications

• Certified Case Manager (CCM).
• Experience working with populations that obtain waiver companies.

To all present Molina staff: If you have an interest in making use of for this place, please apply by way of the Internal Job Board.

Molina Healthcare affords a aggressive advantages and compensation package deal. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $26.41 – $51.49 / HOURLY
*Actual compensation might differ from posting primarily based on geographic location, work expertise, schooling and/or ability degree.

Molina Healthcare is a nationwide fortune 500 group with a mission to supply high quality healthcare to individuals receiving authorities help. If you’re looking for a significant alternative in a team-oriented surroundings, come be part of a extremely engaged workforce devoted to our mission. Bring your ardour and skills and collectively we are able to make a distinction within the lives of others. Molina Healthcare affords a aggressive advantages and compensation package deal. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type Full Time

Posting Date 04/08/2026