Molina Healthcare
Field Care Manager, LTSS (RN) - Local Travel Required - Dallas
Molina Healthcare, Dallas, Texas, United States, 75215
Field Care Manager, LTSS (RN) - Local Travel Required - Dallas
Join
Molina Healthcare
as a Texas‑licensed Registered Nurse to provide care management for Medicaid members in the Dallas, TX service delivery area. You will conduct face‑to‑face meetings in members’ homes, complete assessments to determine eligible services, and coordinate care with multidisciplinary teams. Mileage is reimbursed. Hours: Monday – Friday, 8 AM – 5 PM CST.
Job Summary Provide support for long‑term services and supports (LTSS) and collaborate with the multidisciplinary team to coordinate integrated delivery of member care across the continuum for high‑need members. Strive to ensure member progress toward desired outcomes and contribute to overarching strategy for quality and cost‑effective care.
Essential Job Duties
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, and other health‐care professionals.
Perform ongoing monitoring of care plans to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
Promote integration of behavioral health and LTSS services, 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 change during member contacts.
Assess barriers to care and provide coordination to address psycho/social, financial, and medical obstacles.
Identify critical incidents and develop prevention plans to assure member health and welfare.
Provide consultation, resources, and recommendations to peers as needed.
Manage complex member cases and medication regimens, including medication reconciliation.
Travel locally (25‑40% of time) as required by state and contractual needs.
Required Qualifications
Minimum 2 years of health‑care experience, including at least 1 year in care management, managed care, or a medical/behavioral health setting.
At least 1 year of experience working with individuals with disabilities, chronic conditions, substance abuse disorders, or LTSS, or equivalent education and experience.
Registered Nurse (RN) with active and unrestricted license in Texas.
Valid, unrestricted driver’s license, reliable transportation, and adequate auto insurance for job‑related travel.
Proactive, detail‑oriented, and able to work independently with minimal supervision.
Knowledge of community resources and ability to work within diverse settings and populations.
Excellent time‑management, prioritization, problem‑solving, and critical‑thinking skills.
Strong verbal and written communication skills.
Proficiency in Microsoft Office Suite and related software.
In some states, at least one year of experience working with individuals with substance‑use disorders.
Preferred Qualifications
Certified Case Manager (CCM).
Experience working with populations that receive waiver services.
Molina Healthcare offers a competitive benefits and compensation package. Pay Range: $26.41 – $51.49 per hour. Actual compensation may vary based on geographic location, experience, education, and skill level.
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Seniority Level Entry level
Employment Type Full‑time
Job Function Health Care Provider
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Molina Healthcare
as a Texas‑licensed Registered Nurse to provide care management for Medicaid members in the Dallas, TX service delivery area. You will conduct face‑to‑face meetings in members’ homes, complete assessments to determine eligible services, and coordinate care with multidisciplinary teams. Mileage is reimbursed. Hours: Monday – Friday, 8 AM – 5 PM CST.
Job Summary Provide support for long‑term services and supports (LTSS) and collaborate with the multidisciplinary team to coordinate integrated delivery of member care across the continuum for high‑need members. Strive to ensure member progress toward desired outcomes and contribute to overarching strategy for quality and cost‑effective care.
Essential Job Duties
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, and other health‐care professionals.
Perform ongoing monitoring of care plans to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
Promote integration of behavioral health and LTSS services, 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 change during member contacts.
Assess barriers to care and provide coordination to address psycho/social, financial, and medical obstacles.
Identify critical incidents and develop prevention plans to assure member health and welfare.
Provide consultation, resources, and recommendations to peers as needed.
Manage complex member cases and medication regimens, including medication reconciliation.
Travel locally (25‑40% of time) as required by state and contractual needs.
Required Qualifications
Minimum 2 years of health‑care experience, including at least 1 year in care management, managed care, or a medical/behavioral health setting.
At least 1 year of experience working with individuals with disabilities, chronic conditions, substance abuse disorders, or LTSS, or equivalent education and experience.
Registered Nurse (RN) with active and unrestricted license in Texas.
Valid, unrestricted driver’s license, reliable transportation, and adequate auto insurance for job‑related travel.
Proactive, detail‑oriented, and able to work independently with minimal supervision.
Knowledge of community resources and ability to work within diverse settings and populations.
Excellent time‑management, prioritization, problem‑solving, and critical‑thinking skills.
Strong verbal and written communication skills.
Proficiency in Microsoft Office Suite and related software.
In some states, at least one year of experience working with individuals with substance‑use disorders.
Preferred Qualifications
Certified Case Manager (CCM).
Experience working with populations that receive waiver services.
Molina Healthcare offers a competitive benefits and compensation package. Pay Range: $26.41 – $51.49 per hour. Actual compensation may vary based on geographic location, experience, education, and skill level.
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Seniority Level Entry level
Employment Type Full‑time
Job Function Health Care Provider
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