Telephonic Care Manager, LTSS - MUST RESIDE IN TEXAS

Molina Healthcare; Clifton (TX); On-site; USD 55,000 - 75,000; Full time

Job summary

Molina Healthcare, Inc. is seeking an experienced Case Manager in Texas. Ideal candidates hold LVN, LBSW, or LMSW, or have at least three years of case management experience. The role is Monday–Friday, 8 AM–5 PM CST, with 25–40% travel to support LTSS coordination and multidisciplinary collaboration.

The position emphasizes documentation, care plan development, and interprofessional communication to ensure high-quality, cost-effective member care.

Qualifications

• At least 2 years of health care experience, including experience with disabilities or chronic conditions LTSS.
• Candidate could hold LVN, LBSW, or LMSW, or have equivalent case management experience.
• Strong Microsoft Office proficiency, especially Outlook, Excel, Teams and OneNote.

Responsibilities

• Develops and implements care plans, including waiver service plans in collaboration with members and care network.
• Monitors care plans, documents progress, and suggests changes to improve outcomes.
• Promotes integrated care for LTSS, behavioral health, and home/community resources.
• Assesses medical necessity and authorizes waiver services.
• Coordinates interdisciplinary care team meetings for approval or denial of services.
• Addresses psycho/social, financial, and medical barriers to care.

Skills

Case management experience

Healthcare experience

Time management

Self-motivation

Education

LVN/LBSW/LMSW

Tools

Outlook

Excel

Teams

OneNote

Job description

JOB DESCRIPTION Opportunity for an experienced Case Manager in Texas. Ideal candidate would hold LVN, LBSW, or LMSW, but candidates who have at least three years of Case Management experience will be considered as well. Position is Monday - Friday, 8AM - 5 PM CST.

Solid experience with Microsoft Office Suite is necessary, especially with Outlook, Excel, Teams, and One Note.

Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.

• Performs ongoing monitoring of 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 (LTSS) and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
• Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Collaborates with licensed care managers/leadership as needed or required.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

At least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.

• Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Demonstrated knowledge of community resources.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to work independently, with minimal supervision and self-motivation.
• Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.

Preferred Qualifications

• Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN).