Field Care Manager, LTSS (RN) - Local Travel Required
On-siteFort Worth, Texas, United States
Job Summary
Conduct comprehensive member assessments via in-person home visits and facilitate waiver enrollment and disenrollment processes. Develop and implement care plans, including waiver service plans, in collaboration with members, caregivers, and healthcare professionals to address specific needs and goals. Perform ongoing monitoring of care plans, evaluate effectiveness, document interventions, and suggest changes accordingly. Assess for medical necessity, authorize appropriate waiver services, and evaluate covered benefits while advising on funding sources. Facilitate interdisciplinary care team meetings for service approvals and conduct medication reconciliation as needed. Identify critical incidents, develop prevention plans, and provide care coordination to address psycho-social, financial, and medical obstacles. Utilize motivational interviewing to educate and support members, ensuring progress toward desired outcomes within a multidisciplinary team framework.
Required Qualifications
- At least 2 years of 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
- In some states, a bachelor's degree in a health care related field
- 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
- Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change
- Problem-solving 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
- 25-40% estimated local travel
Desired Qualifications
- Preference will be given to RNs with this type of experience having worked for an MCO organization like Molina
- Solid experience with Microsoft Office Suite, especially with Outlook, Excel, and Teams as well as being confident in moving between different programs to complete the necessary forms and documentation
- Certified Case Manager (CCM)
- Experience working with populations that receive waiver services
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