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

Molina Healthcare•Mission, TX

2h•$26 - $51•Onsite

About The Position

Molina Healthcare is seeking a Texas-licensed Registered Nurse to work as a Field Care Manager with Medicaid members in the Mission, Texas service delivery area. The role completes assessments to determine the services waiver members are eligible to receive. Preference is given to candidates who live within 20 minutes of Mission and to those with prior experience working with Medicaid members in a Managed Care Organization. Local travel is estimated at 25–40%, and mileage is reimbursed as part of the benefits package. The schedule is Monday through Friday, 8 AM to 5 PM CST. The position supports care management and care coordination activities specific to long-term services and supports (LTSS). It collaborates with a multidisciplinary team to coordinate integrated care across the continuum for members with high-need potential, support progress toward desired outcomes, and contribute to quality, cost-effective member care. The role requires confidence using Microsoft Office, particularly Outlook, Excel, and Teams, and moving between programs to complete forms and documentation.

Requirements

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 abuse disorders, or LTSS; an equivalent combination of relevant education and experience may be considered.
Registered Nurse (RN) license that is active and unrestricted in the state of practice; the posting specifically seeks a Texas-licensed RN.
Valid and 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.
Demonstrated knowledge of community resources.
Ability to work in varied settings and adjust one’s approach when working with diverse populations, personalities, and personal situations.
Ability to work independently with minimal supervision and demonstrate self-motivation.
Responsiveness in all forms of communication and ability to remain calm under pressure.
Ability to develop and maintain professional relationships.
Time-management and prioritization skills, including managing multiple projects and adapting to change.
Problem-solving skills.
Strong verbal and written communication skills.
Proficiency with Microsoft Office and applicable software programs.
In some states, at least one year of experience working directly with individuals with substance use disorders is required.
Solid experience with Microsoft Office, especially Outlook, Excel, and Teams, and confidence moving among programs to complete forms and documentation.

Nice To Haves

Certified Case Manager (CCM).
Experience working with populations that receive waiver services.
Previous experience working with the Medicaid population within a Managed Care Organization.
Residence within 20 minutes of Mission, Texas.

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, 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 support 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 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 when assigned.
Conduct medication reconciliation as needed.
Travel locally as required, estimated at 25–40% based on state and contractual requirements.