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

Molina Healthcare•Long Beach, TX

1d•Onsite

About The Position

Molina is seeking a Texas-licensed Registered Nurse to serve as a Field Care Manager supporting Medicaid members in the Tyler, Texas service delivery area. The role provides care management and coordination for long-term services and supports (LTSS), collaborating with a multidisciplinary team to coordinate integrated care for members with high-need potential and to support quality, cost-effective care. The position includes completing eligibility-related assessments, developing and monitoring care plans, coordinating waiver services, and helping members address barriers to care. Local travel, including in-person home visits when required, is part of the role. Candidates must live within 30–45 minutes of the coverage area. The stated schedule is Monday through Friday, 8:00 AM–5:00 PM CST, with an estimated 25–40% local travel depending on state and contractual requirements. Mileage is reimbursed as part of the benefits package. Strong proficiency with Microsoft Office, especially Outlook, Excel, OneNote, and Teams, and the ability to work across multiple programs for forms and documentation are necessary.

Requirements

Registered Nurse (RN) with an active, unrestricted license in the state of practice; the posting specifies Texas licensure for the Tyler service area.
At least 2 years of health care experience, including at least 1 year in care management, managed care, and/or a medical or behavioral health setting, and at least 1 year working with people with disabilities, chronic conditions, substance abuse disorders, and LTSS; an equivalent combination of relevant education and experience is acceptable.
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 operate proactively and work with attention to detail.
Demonstrated knowledge of community resources.
Ability to work in a variety of settings and adapt style when working with diverse populations, personalities, and personal situations.
Ability to work independently with minimal supervision and demonstrate self-motivation.
Responsive communication skills and ability to remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Time-management and prioritization skills, ability to focus on multiple projects, and adaptability to change.
Problem-solving skills.
Strong verbal and written communication skills.
Proficiency with Microsoft Office and applicable software programs.
In some states, at least 1 year of experience working directly with individuals with substance use disorders is required.
Must be within 30–45 minutes of the Tyler coverage area.
Must be able to meet local job-related travel requirements; estimated travel is 25–40%.

Nice To Haves

Certified Case Manager (CCM).
Experience working with populations that receive waiver services.
Previous experience working with the Medicaid population within a Managed Care Organization (MCO) is preferred.

Responsibilities

Complete comprehensive member assessments within regulated timelines, including in-person home visits as required.
Facilitate comprehensive waiver enrollment and disenrollment processes.
Develop and implement care plans, including waiver service plans, in collaboration with members, caregivers, physicians, other health care professionals, and the member’s support network.
Monitor care plans to evaluate effectiveness, document interventions and goal achievement, and recommend changes as appropriate.
Promote integration of behavioral health care, LTSS, and home and community resources to enhance continuity of care.
Assess medical necessity and authorize appropriate waiver services.
Evaluate covered benefits and advise members appropriately regarding funding sources.
Facilitate interdisciplinary care team (ICT) 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.
For assigned complex cases, manage member cases and medication regimens; conduct medication reconciliation as needed.