Field Care Manager, LTSS (RN) - LOCAL TRAVEL REQUIRED
About The Position
Molina Healthcare is seeking a Texas-licensed Registered Nurse to provide long-term services and supports (LTSS) care management for Medicaid members in the El Paso, Texas area. The role includes assessing waiver members to determine eligible services and coordinating integrated care for members with high-need potential. Candidates must live within 30–45 minutes of the coverage area. Local travel is estimated at 25–40%, including in-person home visits as required; mileage is reimbursed. The Field Care Manager collaborates with a multidisciplinary team and members’ support networks to develop and monitor care plans, coordinate services, evaluate medical necessity, and support progress toward desired outcomes. The role contributes to Molina’s goal of providing quality, cost-effective member care. The schedule is Monday through Friday, 8:00 a.m. to 5:00 p.m. CST.
Requirements
- Active, unrestricted Registered Nurse (RN) license in the state of practice; the posting seeks a Texas-licensed RN.
- 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 use disorders, or LTSS; an equivalent combination of relevant education and experience is acceptable.
- 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 adapt to varied settings, diverse populations, personalities, and personal situations.
- Ability to work independently with minimal supervision and demonstrate self-motivation.
- Responsiveness in communications 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 adaptability to change.
- Problem-solving skills.
- Strong verbal and written communication skills.
- Proficiency with Microsoft Office and applicable software, especially Outlook, Excel, OneNote, and Teams; ability to switch between programs to complete forms and documentation.
- In some states, at least one year of experience working directly with individuals with substance use disorders is required.
- In some states, a bachelor's degree in a health care-related field may be required, depending on state or contractual requirements.
- Must live within 30–45 minutes of the El Paso coverage area.
Nice To Haves
- Certified Case Manager (CCM).
- Experience working with populations that receive waiver services.
- Experience with Medicaid populations in a managed care organization (MCO); ICU, ER, or CCU experience is also noted as having prepared RNs for this career transition.
Responsibilities
- Complete comprehensive member assessments within regulated timelines, including required in-person home visits.
- Facilitate waiver enrollment and disenrollment processes.
- Develop and implement care plans and waiver service plans with members, caregivers, physicians, other health care professionals, and support networks.
- Monitor care plans, document interventions and goal achievement, and recommend changes as appropriate.
- Promote integration of behavioral health care, LTSS, and home and community resources.
- Assess medical necessity and authorize appropriate waiver services.
- Evaluate covered benefits and advise members about funding sources.
- Facilitate interdisciplinary care team meetings for service approval or denial and informal collaboration.
- Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate members.
- 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 as assigned.
- Conduct medication reconciliation as needed.
- Travel locally, estimated at 25–40%, based on state and contractual requirements.
Benefits
- Mileage reimbursement as part of the benefits package.
- Competitive benefits and compensation package.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
