Field Care Manager, LTSS - Eastern Cook County -Local Travel Required

Molina Healthcare•Long Beach, CA

2d•Onsite

About The Position

The Field Care Manager supports care management and care coordination activities specific to long-term services and supports (LTSS). The role collaborates with a multidisciplinary team to coordinate integrated member care across the continuum, particularly for members with high-need potential. The position works with Medicaid members in Eastern Cook County and includes face-to-face meetings in members’ homes. Local travel is estimated at 25–40% based on state and contractual requirements; mileage is reimbursed. The position’s stated hours are Monday through Friday, 8 AM to 5 PM CST. The Care Manager helps members progress toward desired outcomes while contributing to quality, cost-effective care.

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 and/or certification only when required by state contract, regulation, business operating model, or state board licensing mandates; any license held must be active and unrestricted in the state of practice.
In some states, a bachelor’s degree in a health care-related field may be required, 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 adjust approach 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.
Responsiveness in all forms of communication 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 simultaneously, and adaptability to change.
Problem-solving skills.
Strong verbal and written communication skills.
Proficiency with Microsoft Office Suite and applicable software, and ability to navigate online portals and databases.
In some states, at least one year of experience working directly with individuals with substance use disorders is required.
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); any license must be active and unrestricted in the state of practice.
Experience working with populations that receive waiver services.
Previous care management experience in a managed care organization (MCO).

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 appropriate health care professionals, and the member’s support network.
Monitor care plans on an ongoing basis, 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 appropriately 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 provide coordination and assistance addressing psychosocial, financial, and medical concerns.
Identify critical incidents and develop prevention plans to assure member health and welfare.
Collaborate with licensed care managers and leadership as needed or required.
Conduct local travel, estimated at 25–40% based on state and contractual requirements.