Field Care Manager, LTSS (RN) - Local Travel Required

Molina Healthcare•Long Beach, TX

9d•Onsite

About The Position

Molina is seeking a Texas-licensed Registered Nurse to work as a Field Care Manager with Medicaid members in the Arlington, Texas area. The role supports care management and care coordination activities specific to long-term services and supports (LTSS), collaborating with a multidisciplinary team to coordinate integrated care for members with high-need potential. The position helps members progress toward desired outcomes while contributing to quality and cost-effective care. Assessments determine the types of services waiver members may be eligible to receive. Candidates must live within 30–45 minutes of the coverage area. Local travel is estimated at 25–40%, depending on state and contractual requirements, and mileage is reimbursed as part of the benefits package. The schedule is Monday through Friday, 8:00 a.m. to 5:00 p.m. CST. The role requires strong Microsoft Office skills, especially Outlook, Excel, OneNote, and Teams, and the ability to move between software programs to complete forms and documentation. Candidates with Medicaid managed care organization experience are preferred; nurses with ICU, ER, or CCU backgrounds have also successfully transitioned into this work.

Requirements

At least 2 years of health care experience, including at least 1 year in care management, managed care, or a medical or behavioral health setting, and at least 1 year working with people with disabilities, chronic conditions, substance abuse disorders, or LTSS; an equivalent combination of relevant education and experience is accepted.
Active, unrestricted Registered Nurse (RN) license in the state of practice.
A bachelor's degree in a health care-related field may be required in some states, depending on state or contractual requirements.
Valid, unrestricted driver's license, reliable transportation, and adequate auto insurance for job-related travel, unless otherwise required by law.
Ability to work proactively and with attention to detail.
Knowledge of community resources.
Ability to work in varied settings and adapt to diverse populations, personalities, and personal situations.
Ability to work independently with minimal supervision and demonstrate self-motivation.
Responsiveness in all forms of communication and ability to remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Time-management and prioritization skills; ability to manage multiple projects and adapt to change.
Problem-solving skills.
Strong verbal and written communication skills.
Proficiency with Microsoft Office and applicable software programs.
In some states, at least one year of experience working directly with individuals with substance use disorders is required.
Must be within 30–45 minutes of the Arlington, Texas coverage area.
Availability to work Monday through Friday, 8:00 a.m. to 5:00 p.m. CST.
Ability to meet local travel requirements, estimated at 25–40%.

Nice To Haves

Certified Case Manager (CCM).
Experience working with populations that receive waiver services.
Previous experience working with Medicaid populations within a managed care organization.
ICU, ER, or CCU nursing background.

Responsibilities

Complete comprehensive member assessments within regulated timelines, including required in-person home visits.
Facilitate comprehensive waiver enrollment and disenrollment processes.
Develop and implement care plans, including waiver service plans, with members, caregivers, physicians, other appropriate health care professionals, and the member's support network.
Monitor care plans, assess their effectiveness, document interventions and goal achievement, and recommend changes as appropriate.
Promote integration of behavioral health care, LTSS, and home and community resources to support continuity of care.
Assess medical necessity and authorize appropriate waiver services.
Evaluate covered benefits and advise members about appropriate funding sources.
Facilitate interdisciplinary care team meetings for service approvals or denials and support informal ICT collaboration.
Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate members during contacts.
Identify barriers to care and coordinate assistance with psychosocial, financial, and medical concerns.
Identify critical incidents and develop prevention plans to protect member health and welfare.
Provide consultation, resources, and recommendations to peers as needed.
Manage complex member cases and medication regimens when assigned.
Conduct medication reconciliation as needed.