Field Care Manager, LTSS (RN) - Central OR West Houston
Molina Healthcare Houston, Texas Job ID 2032411JOB DESCRIPTION
Opportunity for a Texas licensed RN join Molina to work with our Medicare members in the Houston service delivery area. The RN hired to fill this opening will meet with members in EITHER west Houston OR Central Houston. Part of the responsibilities of the role are 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 Medicare population within a Managed Care Organization (MCO). 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.
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: 07/03/2025ABOUT OUR LOCATION
View Map- Medicare Product Development Manager, Vendor Management Fort Worth Texas, Miami Florida, Owensboro Kentucky, Savannah Georgia, Dayton Ohio, Houston Texas, Bellevue Washington, Mesa Arizona, Florida, Albuquerque New Mexico, Columbus Ohio, Akron Ohio, Phoenix Arizona, Cleveland Ohio, Cincinnati Ohio, Iowa City Iowa, Cedar Rapids Iowa, West Valley City Utah, Detroit Michigan, Davenport Iowa, Sterling Heights Michigan, Scottsdale Arizona, Augusta Georgia, Orlando Florida, Omaha Nebraska, Yonkers New York, Provo Utah, Louisville Kentucky, Sioux City Iowa, Austin Texas, Chandler Arizona, Green Bay Wisconsin, Vancouver Washington, Dallas Texas, Kenosha Wisconsin, Roswell New Mexico, Des Moines Iowa, St. Petersburg Florida, Grand Island Nebraska, Spokane Washington, Idaho, Jacksonville Florida, Bellevue Nebraska, Tacoma Washington, Milwaukee Wisconsin, Utah, New York, Racine Wisconsin, Tampa Florida, Albany New York, Lexington-Fayette Kentucky, Ohio, Bowling Green Kentucky, Covington Kentucky, Nebraska, Georgia, Warren Michigan, Atlanta Georgia, New Mexico, Michigan, Tucson Arizona, Las Cruces New Mexico, Grand Rapids Michigan, Macon Georgia, Everett Washington, Wisconsin, Columbus Georgia, Kearney Nebraska, San Antonio Texas, Syracuse New York, Madison Wisconsin, Meridian Idaho, Nampa Idaho, Iowa, Santa Fe New Mexico, Buffalo New York, Washington, Lincoln Nebraska, Rochester New York, Salt Lake City Utah, Orem Utah, Caldwell Idaho, Texas, Rio Rancho New Mexico, Boise Idaho, Layton Utah, Ann Arbor Michigan, Idaho Falls Idaho, Kentucky 07/24/2025
- AVP, Market Share (Remote) Lexington-Fayette Kentucky, Bowling Green Kentucky, Owensboro Kentucky, Tucson Arizona, Rochester New York, Cleveland Ohio, Miami Florida, Scottsdale Arizona, Nebraska, Ohio, St. Petersburg Florida, Ann Arbor Michigan, Orem Utah, Spokane Washington, Boise Idaho, Sioux City Iowa, Nampa Idaho, Kenosha Wisconsin, Syracuse New York, Grand Island Nebraska, Idaho, Washington, Warren Michigan, San Antonio Texas, Austin Texas, Cincinnati Ohio, Louisville Kentucky, Madison Wisconsin, Buffalo New York, Utah, Racine Wisconsin, Jacksonville Florida, Albany New York, Covington Kentucky, Tampa Florida, Fort Worth Texas, Columbus Georgia, Roswell New Mexico, Tacoma Washington, Salt Lake City Utah, Atlanta Georgia, Macon Georgia, Georgia, Meridian Idaho, Everett Washington, Bellevue Nebraska, Columbus Ohio, Cedar Rapids Iowa, Santa Fe New Mexico, Las Cruces New Mexico, Orlando Florida, Green Bay Wisconsin, Yonkers New York, Michigan, Dallas Texas, Omaha Nebraska, Akron Ohio, Layton Utah, Phoenix Arizona, Savannah Georgia, Lincoln Nebraska, Rio Rancho New Mexico, Albuquerque New Mexico, Idaho Falls Idaho, Milwaukee Wisconsin, New Mexico, Wisconsin, Sterling Heights Michigan, Chandler Arizona, Bellevue Washington, Augusta Georgia, Grand Rapids Michigan, Detroit Michigan, Provo Utah, Vancouver Washington, New York, Florida, Mesa Arizona, Davenport Iowa, Iowa City Iowa, Dayton Ohio, Caldwell Idaho, West Valley City Utah, Des Moines Iowa, Kearney Nebraska, Houston Texas, Texas, Kentucky, Iowa 06/19/2025
- Care Management Processor Louisville Kentucky, Lexington-Fayette Kentucky 07/24/2025
- Program Manager -Payment Integrity/Prepayment Solutions (Remote) Cincinnati Ohio, Fort Worth Texas, Des Moines Iowa, Las Cruces New Mexico, Salt Lake City Utah, Mesa Arizona, Iowa, Grand Island Nebraska, Dayton Ohio, Jacksonville Florida, New Mexico, Vancouver Washington, Cedar Rapids Iowa, Bellevue Nebraska, Everett Washington, Idaho, Akron Ohio, West Valley City Utah, Tacoma Washington, Yonkers New York, Tampa Florida, Lexington-Fayette Kentucky, Chandler Arizona, Omaha Nebraska, Texas, Columbus Ohio, Scottsdale Arizona, Houston Texas, Bowling Green Kentucky, Sterling Heights Michigan, Dallas Texas, San Antonio Texas, Atlanta Georgia, Bellevue Washington, Kentucky, Wisconsin, Michigan, Idaho Falls Idaho, Sioux City Iowa, Covington Kentucky, Kenosha Wisconsin, Owensboro Kentucky, Caldwell Idaho, Davenport Iowa, New York, Ohio, Ann Arbor Michigan, Savannah Georgia, Louisville Kentucky, Green Bay Wisconsin, Orlando Florida, Detroit Michigan, Florida, Provo Utah, Layton Utah, Roswell New Mexico, Phoenix Arizona, Kearney Nebraska, Racine Wisconsin, Nampa Idaho, Rio Rancho New Mexico, Columbus Georgia, Albuquerque New Mexico, Madison Wisconsin, Buffalo New York, St. Petersburg Florida, Miami Florida, Milwaukee Wisconsin, Utah, Warren Michigan, Cleveland Ohio, Santa Fe New Mexico, Albany New York, Washington, Macon Georgia, Iowa City Iowa, Lincoln Nebraska, Boise Idaho, Syracuse New York, Grand Rapids Michigan, Georgia, Nebraska, Tucson Arizona, Meridian Idaho, Orem Utah, Augusta Georgia, Rochester New York, Austin Texas, Spokane Washington 07/24/2025
No recently viewed jobs.
View All JobsNo saved jobs.
View All Jobs