Case Manager - RN, LCSW, LMSW, LPC, LMFT - Dallas area - Field Work
Molina Healthcare Dallas, Texas; Fort Worth, Texas; Austin, Texas; Houston, Texas; San Antonio, Texas Job ID 2032049As a Case Manager, you will work 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.
- Full Time
- Level: Mid-Level
- Travel: Yes
Success Profile
What makes you a successful Case Manager at Molina Healthcare? Check out the traits we're looking for and see if you're the right fit.
- Consultative
- Patient
- Analytical
- Quick-Thinking
- Compassionate
- Problem-Solver
I love working at a company that sees our members as people not numbers and allow employees to provide individual care to meet the member’s needs.
-Lori K. MS, BSW, CADC, Case ManagerIf they feel someone cares about them, they are more likely to care for themselves, and their health, in return. Sometimes we have to be their only friend.
-Joanne J., Case ManagerA member’s care is enhanced when their care providers think deeply about their situation and then offer assistance and guidance.
-Brent A., Case ManagerBenefits
-
Insurance
Medical · Dental · Vision
Group & Voluntary Life Insurance
Aflac · Pet Health · Identity Theft
Auto & Home Insurance -
Savings
Flexible Spending Accounts
401K · Roth 401K
Employee Stock Purchase Plan -
Career Growth
Continuing Education Units
Education Reimbursement -
Time Off
Paid Time Off
Volunteer Time Off
Company Holidays -
Additional Perks
Legal Assistance Plan
Employee Assistance & Well Being Programs
Employee Perks Platform
Rideshare Portal
Responsibilities
Job Description
Job Summary
The Sr Specialist, Member & Community Interventions oversees and implements new and existing clinical quality member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid). Executes health plan’s member and community quality focused interventions and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including key performance measurement activities, reports intervention outcomes, and supports continuous improvement of intervention processes and outcomes. Acts as a lead specialist within the department and/or collaboratively with other departments.
Job Duties
- Acts as a lead specialist to provide project, program, and/or initiative related direction and guidance for other specialists within the department and/or collaboratively with other departments
- Implements evidence-based and data-informed member intervention strategies, which may include initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state-required quality activities
- Monitors and ensures that key member intervention activities are completed on time and accurately to present results to key departmental management and other Molina departments as needed
- Writes narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions
- Creates, manages, and/or compiles the required documentation to maintain critical program milestones, deadlines, and/or deliverables
- Participates in quality improvement activities, meetings, and discussions with and between other departments within the organization
- Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with community-based organizations
- Evaluates project/program activities and results to identify opportunities for improvement
- Surfaces to the Manager and Director any gaps in processes that may require remediation
- Other tasks, duties, projects, and programs as assigned
- This position may require same-day out-of-office travel 0 - 80% of the time, depending upon location
- This position may require multiple days out-of-town overnight travel on occasion, depending upon location
Job Qualifications
REQUIRED QUALIFICATIONS:
- Bachelor's Degree or equivalent combination of education and work experience.
- 3 years’ experience in healthcare with a minimum of 2 years’ experience in health plan member interventions, managed care, or equivalent experience.
- Demonstrated solid business writing experience.
- Operational knowledge and experience with Excel and Visio (flow chart equivalent)
- Demonstrates flexibility when it comes to changes and maintains a positive outlook.
- Has excellent problem-solving skills.
PREFERRED QUALIFICATIONS:
- 1 year of experience in Medicare and in Medicaid managed care
- Experience with data reporting, analysis, and/or interpretation
- Certified Professional in Health Quality (CPHQ)
- Nursing License (RN may be preferred for specific roles)
- Certified HEDIS Compliance Auditor (CHCA)
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: $54,922 - $107,099 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 06/17/2025ABOUT OUR LOCATION
View MapNo recently viewed jobs.
View All JobsNo saved jobs.
View All Jobs