Field Care Manager, LTSS (RN)

JOB DESCRIPTION

Opportunity for a Texas licensed RN to affix Molina as a Field Care Manager to work with our Medicare members within the San Antonio service supply space. You will full assessments wanted for figuring out the sorts of companies our members are eligible to obtain. Preference might be given to these candidates with earlier expertise working with the Medicare inhabitants inside a Managed Care Organization (MCO). Mileage is reimbursed as a part of our advantages bundle, however we’re solely contemplating candidates who’re inside 30 – 45 minutes of the protection space. Hours are Monday – Friday, 8 AM – 5 PM CST.

Solid expertise with Microsoft Office Suite is important, particularly with Outlook, Excel, One Note and Teams in addition to being assured in toggling between totally different applications to finish the mandatory types and documentation. 

 Job Summary

Provides help for care administration/care coordination long-term companies and helps particular actions and collaborates with multidisciplinary workforce 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 residence 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 objective achievement, and counsel 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 relating to funding sources.
• Facilitates interdisciplinary care workforce (ICT) conferences for approval or denial of companies and casual ICT collaboration.
• Uses motivational interviewing and Molina medical guideposts to teach, help and encourage change throughout member contacts.
• Assesses for boundaries to care and gives care coordination and help to members to deal with psycho/social, monetary, and medical obstacles issues.
• 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 complicated member instances and drugs regimens.
• Care supervisor RNs could conduct treatment reconciliation as wanted.
• 25-40% estimated native journey could also be required (based mostly upon state/contractual necessities).

Required Qualifications

• At least 2 years expertise in well being care, together with no less than 1 12 months expertise in care administration, managed care, and/or expertise in a medical or behavioral well being setting, and no less than 1 12 months of expertise working with individuals with disabilities, persistent circumstances, substance abuse issues, and long-term companies and helps (LTSS), or equal mixture of related schooling and expertise.
• Registered Nurse (RN). License have to be lively and unrestricted in state of observe.
• Valid and unrestricted driver’s license, dependable transportation, and ample auto insurance coverage for job associated journey necessities, until in any other case required by legislation.
• Ability to function proactively and display detail-oriented work.
• Demonstrated data of neighborhood assets.
• Ability to work inside quite a lot of settings and regulate model as wanted – working with numerous populations and varied 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 preserve skilled relationships.
• Excellent time-management and prioritization expertise, and skill to concentrate on a number of tasks concurrently and adapt to vary.
• 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 no 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 the Internal Job Board.

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

Pay Range: $26.41 – $51.49 / HOURLY
*Actual compensation could fluctuate from posting based mostly on geographic location, work expertise, schooling and/or ability stage.

Molina Healthcare is a nationwide fortune 500 group with a mission to supply high quality healthcare to individuals receiving authorities help. If you might be in search of a significant alternative in a team-oriented setting, come be part of a extremely engaged workforce devoted to our mission. Bring your ardour and abilities and collectively we will make a distinction within the lives of others. Molina Healthcare presents a aggressive advantages and compensation bundle. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type Full Time

Posting Date 05/04/2026