Field Case Manager, LTSS (RN)

Molina Healthcare • Full-time • Mission, TX, United States • 2w ago

JOB DESCRIPTION

Opportunity for TX licensed RN residing in the service delivery area of Hildago and Mission, TX, to join our LTSS Team as a Case Manager working with our Medicaid members. Part of the responsibilities of the role is to conduct face-to-face meetings with the members in their homes, completing assessments needed for determining the types of services we need to provide. Preference will be given to those candidates with previous LTSS experience. 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, Teams, and One Note.

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: $23.76 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Related Jobs

LPN (Licensed Practical Nurse)

Floral Long Term Care • San Juan, US • 1w ago

LPN

LPN (Licensed Practical Nurse) Floral Long Term Care is seeking nurses who are interested in relocating to the USA. We will assist with the relocation and pay very well. LPN (Licensed Practical Nur...

1w ago

VIEW JOB

Field Case Manager, LTSS (RN) - IDD Population

Molina Healthcare • Full-time • Hidalgo, TX, United States • 1m ago

LPN

JOB DESCRIPTION Opportunity for a TX licensed RN to work as a Case Manager with our IDD members. Previous experience with this population is highly preferred. Hours are 8 AM - 5 PM, Monday through Friday and we of...

1m ago

VIEW JOB

Field Case Manager, LTSS (RN)

Molina Healthcare • Full-time • Hidalgo, TX, United States • 2w ago

LPN

JOB DESCRIPTION Opportunity for TX licensed RN residing in the service delivery area of Hildago and Brownsville, TX, to join our LTSS Team as a Case Manager working with our Medicaid members. Part of the responsib...

2w ago

VIEW JOB

SWAT RN Level II RGV- Day Shift

Driscoll Children's Hospital • Full-time • Edinburg, Texas, United States • 3w ago

RN Pediatric

Where compassion meets innovation and technology and our employees are family. Thank you for your interest in joining our team! Please review the job information below. GENERAL PURPOSE OF JOB: The staff nurse...

3w ago

VIEW JOB

RN- Staff Nurse (Long Term Care Facility)

McAllen Nursing Center • Full-time • McAllen, TX, US • 3w ago

Job Purpose: To provide nursing care to residents as prescribed by the physician and in accordance with standards of nursing practices and regulations. Currently offering $3000.00 Sign On Bonus...

3w ago

VIEW JOB

Registered Nurse - PRN Emergency Department

South Texas Health System Edinburg • Per Diem • EDINBURG, Texas, United States • 3w ago

RN ER

Responsibilities POSITION SUMMARY: The RN is responsible for managing patients admitted or being seen for medical conditions or surgical procedures; performs the primary function of a professional nurse leader in...

3w ago

VIEW JOB

New Grad RN Residency Program

HCA Healthcare • Full-time • McAllen, TX, United States • 1m ago

RN New Grad

Description Introduction Do you want to join an organization that invests in you? At Rio Grande Regional Hospital , you come first! HCA Healthcare is committed to the growth and development of our future...

1m ago

VIEW JOB

LVN-PDN-McAllen

Amazing Care Home Health • Full-time • McAllen, TX, US • 2m ago

LVN Home Health

Amazing Care Home Health provides Private Duty Nursing which differs from other Home Health Nursing. Rather than short visits, traveling to multiple patients per shift, you work with one patient per sh...

2m ago

VIEW JOB

Registered Nurse-Recovery Room

Prime Healthcare • Contract • Mission, TX, US • 1w ago

RN PACU

Overview Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Mission Regional Medical Center, a member of Prime Healthcare, offers incredible opport...

1w ago

VIEW JOB

Home Care Aide NEEDED For Elderly Veteran In McAllen, TX

Care Planning Institute, Inc • Full-time • McAllen, TX, US • $26 - $30 / hour • 2w ago

Home Health Aide Home Health

We are a home care aide services agency that has been in business since 2007 and help elderly people stay safe and well in their homes. We provide home care services in 15 states. We also offer same day pay options for...

2w ago

VIEW JOB