Field Case Manager, LTSS (RN)

Molina Healthcare • Full-time • Conroe, TX, United States • 1w ago

JOB DESCRIPTION

Opportunity for TX licensed RN to join Molina as a Case Manager working with our Medicaid members in the service delivery area of Conroe, Bay City, and Spring, TX. 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 experience working with the LTSS population. 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: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Related Jobs

LPN - Hourly

AMSURG • Full-time • Conroe, Texas, United States • 4m ago

LPN

LPN/LVN needed to perform and document pre-operative baseline assessment for each patient. Assessment is done over the phone. River Oaks Endoscopy is a busy ASC seeing approximately 800 patients a month. Pre-operative a...

4m ago

VIEW JOB

Registered Weekend Nurse-RN Home Health PRN

Elara Caring • Per Diem • Conroe, Texas, United States • 3d ago

RN Home Health

At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here, each employee has the chance to make a real difference by carrying out our mission every day. Join o...

3d ago

VIEW JOB

Registered Nurse

DaVita • Full-time • The Woodlands, Texas 77384, United States • 2w ago

17191 St Lukes WaySte 100, The Woodlands, Texas, 77384-8042, United States of America DaVita is seeking a Nurse who is looking to give life in an outpatient dialysis center. You can make an exceptional difference in th...

2w ago

VIEW JOB

Caregiver

Heritage Oaks Assisted Living and Memory Care • Full-time • Conroe, TX, US • 3w ago

Caregiver Memory Care

Are you looking for a new best friend, card-game companion, or gardening guru? Then consider working with one of our light, bright, and beautiful Assisted Living and Memory Care communities – where our residents are #1...

3w ago

VIEW JOB

Hospitalist Nurse Practitioner

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

Description Specialization: Internal Medicine Job Summary: This position represents an excellent professional and financial opportunity for a motivated hospitalist advanced practice providers in Conroe, TX....

1m ago

VIEW JOB

CMA, LVN or RN - The Woodlands

Inception Fertility • Full-time • Shenandoah, Texas, United States • 5d ago

CMA

Aspire HFI is a high-volume infertility practice that seeks a caring, compassionate CMA, LVN or RN with attention to detail for their office. Hours: 7:30 a.m. - 5:00 p.m., Monday - Friday, no weekends and only...

5d ago

VIEW JOB

CDI RN Specialist

Conifer Revenue Cycle Solutions • Full-time • The Woodlands, TX • 3w ago

JOB SUMMARY Responsible for reviewing medical records to facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected...

3w ago

VIEW JOB

Advanced Practice Provider NP/PA

American Family Care • Part-time • The Woodlands, TX, US • $60 - $70 / hour • 1m ago

NP Urgent Care

Benefits/Perks Great small business work environment Flexible scheduling Company Overview American Family Care (AFC) is one of the largest primary and urgent care companies in the U.S. providing service...

1m ago

VIEW JOB

Visiting Registered Nurse (RN)

At Home Quality Care • Full-time • The Woodlands, TX, US • $50 - $100 / hour • 1w ago

RN Home Health

JobTitle/Position: Registered Nurse(RN)/Case Manager Pay: $50 per regular visit, $100 per start of care Benefits: Mileage and travel reimbursement. Company paid cellular data. 401k (with match). Reports To: D...

1w ago

VIEW JOB

Advanced Practice Provider, Cardiology @ The Woodlands

Memorial Hermann Health System • Full-time • The Woodlands, Texas, United States • 1w ago

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes...

1w ago

VIEW JOB