Field Care Manager, LTSS (RN)

Molina Healthcare; San Antonio (TX); On-site; USD 80,000 - 100,000; Full time

Job summary

Molina Healthcare is seeking a Field Care Manager, LTSS (RN) to work with Medicare members in San Antonio, TX. The role involves conducting assessments, coordinating care plans, and providing support to members. Candidates with experience in managed care, especially with the Medicare population, are preferred. This full-time position offers a competitive salary and includes reimbursement for mileage.

Benefits

Mileage reimbursement

Comprehensive benefits package

Qualifications

• Active, unrestricted State Registered Nursing license (RN) in good standing.
• 1-3 years experience in managed care or behavioral health settings.
• Experience with persons with disabilities/chronic conditions required.

Responsibilities

• Conduct face-to-face assessments and develop care plans for members.
• Facilitate enrollment and ongoing monitoring of care plans.
• Travel 50-75% for home visits to members.

Skills

Motivational Interviewing

Assessment

Care Coordination

Education

Graduate from an Accredited School of Nursing

Bachelor's Degree in Nursing

Tools

Microsoft Office Suite

Job description

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Job Description

Opportunity for a Texas licensed RN to join Molina to work with our Medicare members in the San Antonio, TX service delivery areas. Part of the responsibilities of the role is to conduct face-to-face meetings with the members in their homes, completing assessments to determine the types of services we need to provide. Preference will be given to those candidates with previous experience working with the Medicare population within a Managed Care Organization (MCO). Mileage is reimbursed as part of our benefits package. Hours are Monday – Friday, 8 AM – 5 PM CST.

Job Description

Opportunity for a Texas licensed RN to join Molina to work with our Medicare members in the San Antonio, TX service delivery areas. Part of the responsibilities of the role is to conduct face-to-face meetings with the members in their homes, completing assessments to determine the types of services we need to provide. Preference will be given to those candidates with previous experience working with the Medicare population within a Managed Care Organization (MCO). Mileage is reimbursed as part of our benefits package. Hours are Monday – Friday, 8 AM – 5 PM CST.

Solid experience with Microsoft Office Suite is necessary, especially with Outlook, Excel, and Teams as well as being confident in moving between different programs to complete the necessary forms and documentation.

Job Summary

Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

Knowledge/Skills/Abilities

• Completes face-to-face comprehensive assessments of members per regulated timelines.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements a case management plan, including a waiver service plan, in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.
• Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long term services and supports, home and community to enhance the continuity of care for Molina members.
• Assesses for medical necessity and authorize all appropriate waiver services.
• Evaluates covered benefits and advise appropriately regarding funding source.
• Conducts face-to-face or home visits as required.
• Facilitates interdisciplinary care team meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member's health and welfare.
• Provides consultation, recommendations and education as appropriate to non-RN case managers
• Works cases with members who have complex medical conditions and medication regimens
• Conducts medication reconciliation when needed.
• 50-75% travel required.
  
  

Job Qualifications

Required Education

Graduate from an Accredited School of Nursing

Required Experience

• At least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports.
• 1-3 years in case management, disease management, managed care or medical or behavioral health settings.
• Required License, Certification, Association
• Active, unrestricted State Registered Nursing license (RN) in good standing
• If field work is required, Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
  
  

State Specific Requirements

Virginia: Must have at least one year of experience working directly with individuals with Substance Use Disorders

Preferred Education

Bachelor's Degree in Nursing

Preferred Experience

• 3-5 years in case management, disease management, managed care or medical or behavioral health settings.
• 1 year experience working with population who receive waiver services.
  
  

Preferred License, Certification, Association

Active and unrestricted Certified Case Manager (CCM)

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $26.41 - $51.49 / HOURLY

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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