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

Molina Healthcare•Long Beach, CA

1d•Onsite

About The Position

Provides support for care management and care coordination activities specific to long-term services and supports (LTSS). The Field Care Manager collaborates with a multidisciplinary team to coordinate integrated care across the continuum for members with high-need potential, helping members progress toward desired outcomes while contributing to quality, cost-effective care. The role serves Medicaid members in Eastern Cook County, in communities between Wicker Park north to West Montrose Avenue. It includes face-to-face meetings with members in their homes and an estimated 25–40% local travel, depending on state and contractual requirements. Mileage is reimbursed. The work schedule is Monday through Friday, 8 AM to 5 PM CST.

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 of care management experience, 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 licensing mandates; 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 adjust approach when working with diverse populations, personalities, and personal situations.
Proactive approach and 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 manage multiple projects simultaneously, and adaptability to change.
Problem-solving skills.
Strong verbal and written communication skills.
Proficiency with Microsoft Office Suite and applicable software, including Outlook, Excel, and Teams; ability to navigate online portals, databases, and different programs to complete forms and documentation.
In some states, at least 1 year of experience working directly with individuals with substance use disorders.

Nice To Haves

Preference for candidates with previous care management experience in a managed care organization (MCO).
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.

Responsibilities

Complete comprehensive member assessments within regulated timelines, including in-person home visits as 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 member support networks.
Monitor care plans to 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 about appropriate 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 addressing members’ psychosocial, financial, and medical concerns.
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.
Conduct face-to-face meetings with members in their homes.
Travel locally as required, estimated at 25–40% based on state and contractual requirements.