Field Care Manager - LTSS
$26.41 - $51.49/hr+ Mileage reimbursement
Mid
Hutchins, TX, USA+3 moreMore locations: Duncanville, TX, USA | DeSoto, TX, USA | Lancaster, TX, USA
HybridLocal travel of 25–40% may be required.
Medical, Clinical & Veterinary
About the job
Requirements
- At least 2 years of experience in health care, including at least 1 year of experience in care management, managed care, or 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 an equivalent combination of relevant education and experience.
- Registered Nurse (RN) with an active, unrestricted license in the state of practice.
- In some states, a bachelor's degree in a health care-related field may be required, depending on state or contractual requirements.
- Valid, unrestricted driver's license, reliable transportation, and adequate auto insurance for job-related travel, unless otherwise required by law.
- Ability to operate proactively and perform detail-oriented work.
- Demonstrated knowledge of community resources.
- Ability to work across a variety of settings and adjust style when working with diverse populations, 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, ability to focus on multiple projects simultaneously, and adaptability to change.
- Problem-solving skills.
- Strong verbal and written communication skills.
- Proficiency with Microsoft Office Suite and applicable software programs.
- In some states, at least one year of experience working directly with individuals with substance use disorders is required.
Responsibilities
- Complete comprehensive member assessments within regulated timelines, including in-person home visits as required.
- Facilitate comprehensive waiver enrollment and disenrollment processes.
- Develop and implement care plans, including waiver service plans, in collaboration with members, caregivers, physicians or other appropriate health care professionals, and the member's support network to address member needs and goals.
- Monitor care plans on an ongoing basis to evaluate effectiveness, document interventions and goal achievement, and suggest changes as appropriate.
- Promote integration of services for members, including behavioral health care, LTSS, and home and community resources, to enhance continuity of care.
- Assess medical necessity and authorize appropriate waiver services.
- Evaluate covered benefits and advise appropriately regarding funding sources.
- Facilitate interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
- Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate change during member contacts.
- Assess barriers to care and provide care coordination and assistance to address members' psychosocial, financial, and medical obstacles.
- Identify critical incidents and develop prevention plans to assure member health and welfare.
- Provide consultation, resources, and recommendations to peers as needed.
- Handle complex member cases and medication regimens as assigned to care manager RNs.
- Conduct medication reconciliation as needed.
- Make local work-related trips; estimated travel may be 25–40% depending on state and contractual requirements.
Desired Qualifications
- Previous experience working with the Medicare population within a Managed Care Organization (MCO).
- Certified Case Manager (CCM).
- Experience working with populations that receive waiver services.
About the company
Molina Healthcare runs health insurance plans for people covered by Medicaid, Medicare and state insurance marketplaces, with a focus on people who need affordable access to care. Its local health plans coordinate medical services and support members with complex health needs, including people eligible for both Medicaid and Medicare. Members receive care through networks of doctors, hospitals and other providers, while the plans manage benefits, process claims and arrange care support. The company earns premiums from government programs and members, and pays the cost of covered healthcare services. Molina was founded in 1980 and is headquartered in Long Beach, California.
Company Size
10,001+
Company Stage
IPO
Headquarters
Long Beach, California
Founded
1980
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Simplify's Take
What believers are saying
- Illinois continuity gained ground: June 2026 brought an intended Molina Medicaid contract award for four-and-a-half years.
- Recovery has a higher target: Molina raised adjusted earnings guidance to $5.25 per share in July 2026.
- Career development has a named route: Molina's Pathways to Success helps staff navigate careers across the organization.
What critics are saying
- Profits remain under pressure: Molina reported a 76% quarterly net income decline in July 2026.
- Margins are fragile: Molina estimates one additional medical spending percentage point cuts 2025 earnings per share by $6.20.
- Remote still means travel: Molina's California site review nurse role requires field visits three to four days weekly.
What makes Molina Healthcare unique
- Pharmacy work goes outside: Molina outsources drug benefits administration to CVS Caremark.
- Wisconsin work includes long-term care: Molina's My Choice Wisconsin runs Family Care and Partnership programs.
- Connecticut retains a local brand: Molina owns ConnectiCare, a health plan focused on the state.
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Benefits
- Health Insurance
- 401(k) Retirement Plan
- Remote Work Options
- Paid Vacation
- Flexible Work Hours
- Wellness Program
- Mental Health Support
- Conference Attendance Budget
- Professional Development Budget
- Phone/Internet Stipend
- Home Office Stipend
- Family Planning Benefits