Field Care Manager, LTSS (RN) - Local Travel Required

divh2Field Care Manager/h2pOpportunity for a Texas licensed RN to join Molina as a Field Care Manager to work with our Medicare members in the San Antonio service delivery area. You will complete assessments needed for determining the types of services our members are eligible to receive. 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, but we are only considering candidates who are within 30 45 minutes of the coverage area. Hours are Monday Friday, 8 AM 5 PM CST./ppSolid experience with Microsoft Office Suite is necessary, especially with Outlook, Excel, One Note and Teams as well as being confident in toggling between different programs to complete the necessary forms and documentation./ppProvides support for care management/care coordination long-term services and supports specific activities and 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./ppEssential Job Duties/pulliCompletes comprehensive member assessments within regulated timelines, including in-person home visits as required./liliFacilitates comprehensive waiver enrollment and disenrollment processes./liliDevelops 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./liliPerforms ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly./liliPromotes 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./liliAssesses for medical necessity and authorizes all appropriate waiver services./liliEvaluates covered benefits and advises appropriately regarding funding sources./liliFacilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration./liliUses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts./liliAssesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns./liliIdentifies critical incidents and develops prevention plans to assure member health and welfare./liliMay provide consultation, resources and recommendations to peers as needed./liliCare manager RNs may be assigned complex member cases and medication regimens./liliCare manager RNs may conduct medication reconciliation as needed./lili25-40% estimated local travel may be required (based upon state/contractual requirements)./li/ulpRequired Qualifications/pulliAt least 2 years experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience./liliRegistered Nurse (RN). License must be active and unrestricted in state of practice./liliValid and unrestricted drivers license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law./liliAbility to operate proactively and demonstrate detail-oriented work./liliDemonstrated knowledge of community resources./liliAbility to work within a variety of settings and adjust style as needed - working with diverse populations and various personalities and personal situations./liliAbility to work independently, with minimal supervision and demonstrate self-motivation./liliResponsiveness in all forms of communication, and ability to remain calm in high-pressure situations./liliAbility to develop and maintain professional relationships./liliExcellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change./liliExcellent problem-solving and critical-thinking skills./liliStrong verbal and written communication skills./liliMicrosoft Office suite/applicable software program(s) proficiency./liliIn some states, must have at least one year of experience working directly with individuals with substance use disorders./li/ulpPreferred Qualifications/pulliCertified Case Manager (CCM)./liliExperience working with populations that receive waiver services./li/ulpPay Range: $26.41 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level./p/div