RN Field Care Manager Medicaid LTSS Navigator

Molina Healthcare; Houston (TX); Hybrid; USD 36,000 - 71,000; Full time

Benefits offered by this job

Mileage reimbursement

Job summary

Molina Healthcare is seeking a Texas-licensed RN to join as a Field Care Manager in the Houston area to support Medicaid members. You will perform assessments, coordinate LTSS services, and work with a multidisciplinary team to ensure high-quality, cost-effective member care.

Travel up to 25-40% is required; strong MS Office skills and experience with Medicaid/MCO settings are preferred. Hours are typically Monday–Friday, 8 AM–5 PM CST.

Qualifications

• RN license active and unrestricted in state of practice.
• 2+ years healthcare experience including care management or managed care.
• Experience with populations with disabilities, chronic conditions, substance use disorders, and LTSS preferred.
• Valid driver’s license and reliable transportation for local travel.

Responsibilities

• Complete comprehensive member assessments within timelines, including in-person home visits as required.
• Facilitate waiver enrollment and disenrollment processes.
• Develop and implement care plans with member, caregivers, and physicians.
• Monitor care plan effectiveness and document progress and changes.
• Promote integration of behavioral health and LTSS services for continuity of care.
• Assess medical necessity and authorize waiver services.
• Coordinate ICT meetings for service approvals/denials.
• Educate and motivate members using motivational interviewing.
• Identify barriers and coordinate care to address psycho/social, financial, and medical needs.
• Identify critical incidents and develop prevention plans.
• May provide consultation to peers and handle complex member cases.

Education

Registered Nurse (RN) license

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Texas-licensed RN to join as a Field Care Manager in the Houston area to support Medicaid members. You will perform assessments, coordinate LTSS services, and work with a multidisciplinary team to ensure high-quality, cost-effective member care.

Travel up to 25-40% is required; strong MS Office skills and experience with Medicaid/MCO settings are preferred. Hours are typically Monday–Friday, 8 AM–5 PM CST.