Field Care Manager, LTSS (LVN) - LOCAL TRAVEL REQUIRED

Molina Healthcare•Long Beach, TX

About The Position

Molina is hiring a Field Care Manager to support care management and care coordination activities specific to long-term services and supports (LTSS). The role collaborates with a multidisciplinary team to coordinate integrated care across the continuum for members with high-need potential, supporting progress toward desired outcomes and quality, cost-effective care. This opportunity serves Medicaid members in the Arlington, Texas service delivery area and includes in-home, face-to-face assessments with non-waiver Medicaid members. The role requires bilingual ability and local travel; mileage is reimbursed as part of the benefits package. The stated schedule is Monday through Friday, 8 a.m. to 5 p.m. CST. The position completes member assessments, supports waiver enrollment and disenrollment, develops and monitors care plans, coordinates services and resources, assesses medical necessity, and facilitates interdisciplinary care team collaboration. It also addresses barriers to care, identifies critical incidents, and works with licensed care managers and leadership as needed.

Requirements

At least 2 years of health care experience, including at least 1 year working with persons with disabilities or chronic conditions in LTSS and 1 year in care management, or experience in a medical and/or behavioral health setting, or an equivalent combination of relevant education and experience.
Clinical licensure or certification is required only when mandated by state contract, regulation, business operating model, or state board requirements; any license held must be active and unrestricted 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 and unrestricted driver's license, reliable transportation, and adequate auto insurance for work-related travel, unless otherwise required by law.
Demonstrated knowledge of community resources.
Ability to work in varied settings and adapt to diverse populations, personalities, and personal situations.
Proactive, detail-oriented approach to work.
Ability to work independently with minimal supervision and demonstrate self-motivation.
Ability to respond to communications and remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Time-management and prioritization skills, with the 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, and ability to navigate online portals and databases.
Bilingual ability.
Solid experience with Microsoft Office, especially Outlook, Excel, and Teams, and confidence moving between programs to complete forms and documentation.
In some states, at least 1 year of experience working directly with individuals with substance use disorders.

Nice To Haves

Certified Case Manager (CCM), Licensed Vocational Nurse (LVN), or Licensed Practical Nurse (LPN); any license must be active and unrestricted in the state of practice.
Experience working with populations that receive waiver services.
Experience completing in-home, face-to-face assessments for non-waiver Medicaid members.
Experience in an MCO organization such as Molina.

Responsibilities

Complete comprehensive member assessments within regulated timelines, including in-person home visits when 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 suggest 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 about appropriate funding sources.
Facilitate interdisciplinary care team meetings for service approval or denial and informal team collaboration.
Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate members during contacts.
Assess barriers to care and coordinate assistance with psychosocial, financial, and medical obstacles.
Identify critical incidents and develop prevention plans to help assure member health and welfare.
Collaborate with licensed care managers and leadership as needed or required.
Complete local travel, estimated at 25–40% depending on state and contractual requirements.