Field Care Manager, LTSS (RN) - Local Travel Required
10 days ago
Beaumont
JOB DESCRIPTION Job Summary \n Provides 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. \n Essential Job Duties \n • Completes comprehensive member assessments within regulated timelines, including in-person home visits as required., • Facilitates comprehensive waiver enrollment and disenrollment processes., • 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., • Evaluates covered benefits and advises appropriately regarding funding sources., • Facilitates interdisciplinary care team (ICT) 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 and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns., • Identifies critical incidents and develops prevention plans to assure member health and welfare., • May provide consultation, resources and recommendations to peers as needed., • Care manager RNs may be assigned complex member cases and medication regimens., • Care manager RNs may conduct medication reconciliation as needed., • 25-40% estimated local travel may be required (based upon state/contractual requirements). \n Required Qualifications \n • At 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., • Registered Nurse (RN). License must be active and unrestricted in state of practice., • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law., • Ability to operate proactively and demonstrate detail-oriented work., • Demonstrated knowledge of community resources., • Ability to work within a variety of settings and adjust style as needed - working with diverse populations and various personalities and personal situations., • Ability to work independently, with minimal supervision and demonstrate self-motivation., • Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations., • Ability to develop and maintain professional relationships., • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change., • Excellent problem-solving and critical-thinking skills., • Strong verbal and written communication skills., • Microsoft Office suite/applicable software program(s) proficiency., • In some states, must have at least one year of experience working directly with individuals with substance use disorders. \n Preferred Qualifications \n • Certified Case Manager (CCM)., • Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 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.