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

Molina Healthcare•Long Beach, CA

16h

About The Position

The Field Care Manager provides support for long-term services and supports (LTSS) care management and coordination. The role collaborates with a multidisciplinary team to coordinate integrated member care across the continuum, particularly for members with high-need potential, and works to support progress toward desired outcomes and quality, cost-effective care. The position serves Medicaid members in the Jasper and Livingston, Texas area and involves face-to-face home visits to complete assessments used to determine eligible services. The role follows Monday through Friday hours, 8 AM to 5 PM CST, with an estimated 25–40% of work time spent on local travel, depending on state and contractual requirements. Mileage is reimbursed.

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, a medical or behavioral health setting, or an equivalent combination of relevant education and experience.
If required by state contract, regulation, business operating model, or licensing mandates, hold the applicable clinical licensure or certification; any license 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 one's style when working with diverse populations, personalities, and personal situations.
Ability to work proactively and with attention to detail.
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, ability to manage multiple projects simultaneously, and adaptability to change.
Problem-solving skills.
Strong verbal and written communication skills.
Proficiency with Microsoft Office or applicable software and ability to navigate online portals and databases.
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.
Previous experience working with the LTSS population within 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 health care professionals, and member support networks.
Monitor care plans on an ongoing basis, 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 regarding funding sources.
Facilitate interdisciplinary care team (ICT) meetings for service approval or denial and informal ICT collaboration.
Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate members during contacts.
Assess barriers to care and coordinate care and assistance to address 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.