Field Care Manager, LTSS (RN) - Local Travel Required
On-siteMission, Texas, United States
Job Summary
Conduct comprehensive member assessments within regulated timelines, including in-person home visits, and facilitate waiver enrollment and disenrollment processes. Develop and implement care plans in collaboration with members, caregivers, physicians, and other health care professionals to address specific needs and goals. Perform ongoing monitoring of care plans to evaluate effectiveness, document interventions, and suggest changes, while assessing for medical necessity to authorize appropriate waiver services. Facilitate interdisciplinary care team meetings for service approvals and provide consultation on critical incidents and prevention plans. Hours are Monday through Friday, 8 AM to 5 PM CST, with 25-40% estimated local travel required. Reimbursement for mileage is included in the benefits package. This role supports high-need Medicaid members in the Mission, TX service delivery area, focusing on long-term services and supports (LTSS) and integrated delivery of care.
Required Qualifications
- Texas licensed RN
- 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 those candidates with previous experience working with the Medicaid population within a Managed Care Organization (MCO)
- Certified Case Manager (CCM)
- Experience working with populations that receive waiver services
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