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

Molina Healthcare•Long Beach, TX

11d

About The Position

Molina Healthcare is hiring a Field Care Manager to support long-term services and supports (LTSS) care management and care coordination for Medicaid members in the Katy and Stafford areas of the Houston, Texas service delivery area. The role coordinates integrated care for members with high-need potential, helping members progress toward desired outcomes while contributing to quality and cost-effective care. It includes in-home, face-to-face assessments and local travel estimated at 25–40%, depending on state and contractual requirements. The position requires bilingual ability. The stated schedule is Monday through Friday, 8 AM to 5 PM CST, and mileage is reimbursed. The Care Manager works with members, caregivers, physicians, other health professionals, and member support networks to assess needs, develop and monitor care plans, coordinate services, and address barriers to care. The role also supports waiver enrollment and disenrollment, evaluates medical necessity and covered benefits, facilitates interdisciplinary care team meetings, and identifies critical incidents and prevention strategies.

Requirements

At least 2 years of health care experience, including at least 1 year working with people with disabilities or chronic conditions in LTSS and 1 year in care management, or experience in a medical 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 licensing 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 job-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 and ability to work independently with minimal supervision.
Ability to respond to communications, remain calm under pressure, and develop and maintain professional relationships.
Time-management and prioritization skills, ability to manage multiple projects, and adaptability to change.
Problem-solving skills and strong verbal and written communication skills.
Proficiency with Microsoft Office and applicable software, and ability to navigate online portals and databases.
At least 1 year of experience working directly with individuals with substance use disorders may be required in some states.
Bilingual ability.
Solid experience with Microsoft Office Suite, especially Outlook, Excel, and Teams, and confidence moving between programs to complete forms and documentation.

Nice To Haves

Certified Case Manager (CCM).
Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN), with an active and unrestricted license in the state of practice.
Experience working with populations that receive waiver services.
Preference for registered nurses with relevant experience at a managed care organization (MCO).

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, in collaboration with members, caregivers, physicians, other appropriate health professionals, and member support networks.
Monitor care plans, evaluate effectiveness, document interventions and goal achievement, and recommend changes.
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 support informal ICT collaboration.
Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate members during contacts.
Assess barriers to care and coordinate assistance for psychosocial, financial, and medical concerns.
Identify critical incidents and develop prevention plans to protect member health and welfare.
Collaborate with licensed care managers and leadership as needed or required.