Subject Care Manager, LTSS (RN)

JOB DESCRIPTION

Opportunity for a Texas licensed RN to affix Molina to work with our Medicaid members within the Sugarland and Fresno service supply areas, finishing assessments wanted for figuring out the sorts of providers they’re 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 bundle. 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 transferring between totally different packages to finish the mandatory kinds and documentation.

Job Summary

Provides assist for care administration/care coordination long-term providers 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 dwelling 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 acceptable well being care professionals and member assist community to handle the member wants and objectives.
• Performs ongoing monitoring of care plan to guage effectiveness, doc interventions and objective achievement, and counsel modifications accordingly.
• Promotes integration of providers for members together with behavioral well being care and long-term providers and helps (LTSS) and residential and neighborhood assets to boost continuity of care.
• Assesses for medical necessity and authorizes all acceptable waiver providers.
• Evaluates lined advantages and advises appropriately concerning funding sources.
• Facilitates interdisciplinary care staff (ICT) conferences for approval or denial of providers and casual ICT collaboration.
• Uses motivational interviewing and Molina medical guideposts to coach, assist and encourage change throughout member contacts.
• Assesses for obstacles to care and supplies care coordination and help to members to handle psycho/social, monetary, and medical obstacles issues.
• Identifies important 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 drugs regimens.
• Care supervisor RNs could conduct medicine 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 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, power situations, substance abuse issues, and long-term providers and helps (LTSS), or equal mixture of related training and expertise.
• Registered Nurse (RN). License should be lively and unrestricted in state of apply.
• Valid and unrestricted driver’s license, dependable transportation, and satisfactory auto insurance coverage for job associated journey necessities, until in any other case required by legislation.
• Ability to function proactively and show 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 varied personalities and private conditions.
• Ability to work independently, with minimal supervision and show self-motivation.
• Responsiveness in all types of communication, and talent to stay calm in high-pressure conditions.
• Ability to develop and preserve skilled relationships.
• Excellent time-management and prioritization abilities, and talent to give attention to a number of tasks concurrently and adapt to alter.
• Excellent problem-solving and critical-thinking abilities.
• Strong verbal and written communication abilities.
• Microsoft Office suite/relevant software program program(s) proficiency.
• In some states, should have no less than one 12 months of expertise working straight with people with substance use issues.

Preferred Qualifications

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

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

Molina Healthcare affords 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 range from posting primarily based on geographic location, work expertise, training and/or ability stage.

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

Job Type Full Time

Posting Date 10/06/2025