Telephonic Complex Case Care Manager, LTSS (RN) - MUST Reside in Texas
Molina Healthcare · Texas, United States · 1 mo ago
RemoteRemoteOTHR$26.41–$51.49/hrFull-time
We need to output HTML fragment with sections: About the role? The posting includes Job Description, Job Summary, Essential Job Duties, Required Qualifications, Preferred Qualifications, Pay Range, Hours (Schedule). Also mention location: TX licensed RN, residing in Texas, telephonically, hours Monday-Friday 8-5 CST working from home, travel 25-40% local.
We need headings: for sections like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We should map content accordingly.
We must not repeat job title as heading. No Job ID. Remove boilerplate: EEO, etc. Also remove application instructions (To all current Molina employees...). Also remove duplicated lines.
We need to preserve all substantive info. So include details: TX licensed RN residing in Texas, experience as Care Manager with complex/intensive cases, telephonic assessments, managing care until discharge, ideal candidate experience as Case Manager within MCO like Molina, also consider RNs with strong background in complex cases. Hours Monday-Friday 8 AM-5 PM CST working from home. Solid experience with Microsoft Office Suite (Outlook, Excel, Teams) and moving between programs. Excellent computer skills, attention to detail, multitask, fast-paced, productivity important.
Job Summary: Provide support for care management/care coordination LTSS-specific activities. Collaborate with multidisciplinary team coordinating integrated delivery of member care across continuum for members with high-need potential. Strive to ensure member progress toward desired outcomes and contribute to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties: list bullet points.
Required Qualifications: bullet list.
Preferred Qualifications: bullet list.
Pay: $26.41 - $51.49 / HOURLY (note actual compensation may vary). Should we include that note? It's substantive. We'll include.
Schedule: Monday-Friday 8 AM-5 PM CST, working from home, 25-40% estimated local travel may be required.
Benefits: The posting mentions "Molina Healthcare offers a competitive benefits and compensation package." No specifics. Should we include Benefits section? The rule: include a section ONLY when posting has real, specific content for it. "competitive benefits and compensation package" is vague but still mentions benefits. However it's not specific like health insurance, 401k, etc. Might be considered filler? The instruction: never emit a heading followed by filler/placeholder text (e.g., "commensurate with experience", "not specified", "N/A", "varies", "TBD"). "competitive benefits and compensation package" is somewhat vague but not exactly placeholder. Might be okay to include Benefits section with that sentence. But we could also omit Benefits if we deem it too vague. The instruction: Prefer a few substantive sections over many thin ones. So maybe we omit Benefits.
Skills: Could be covered under Required Qualifications (Microsoft Office suite, etc.) but we could have a Skills section. However we already have Required Qualifications covering skills. Might be redundant. Better to have sections: About the role (maybe Job Summary), Responsibilities (Essential Job Duties), Requirements (Required Qualifications), Preferred Qualifications, Pay, Schedule.
We need to use
for sections like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We should map content accordingly.
We must not repeat job title as heading. No Job ID. Remove boilerplate: EEO, etc. Also remove application instructions (To all current Molina employees...). Also remove duplicated lines.
We need to preserve all substantive info. So include details: TX licensed RN residing in Texas, experience as Care Manager with complex/intensive cases, telephonic assessments, managing care until discharge, ideal candidate experience as Case Manager within MCO like Molina, also consider RNs with strong background in complex cases. Hours Monday-Friday 8 AM-5 PM CST working from home. Solid experience with Microsoft Office Suite (Outlook, Excel, Teams) and moving between programs. Excellent computer skills, attention to detail, multitask, fast-paced, productivity important.
Job Summary: Provide support for care management/care coordination LTSS-specific activities. Collaborate with multidisciplinary team coordinating integrated delivery of member care across continuum for members with high-need potential. Strive to ensure member progress toward desired outcomes and contribute to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties: list bullet points.
Required Qualifications: bullet list.
Preferred Qualifications: bullet list.
Pay: $26.41 - $51.49 / HOURLY (note actual compensation may vary). Should we include that note? It's substantive. We'll include.
Schedule: Monday-Friday 8 AM-5 PM CST, working from home, 25-40% estimated local travel may be required.
Benefits: The posting mentions "Molina Healthcare offers a competitive benefits and compensation package." No specifics. Should we include Benefits section? The rule: include a section ONLY when posting has real, specific content for it. "competitive benefits and compensation package" is vague but still mentions benefits. However it's not specific like health insurance, 401k, etc. Might be considered filler? The instruction: never emit a heading followed by filler/placeholder text (e.g., "commensurate with experience", "not specified", "N/A", "varies", "TBD"). "competitive benefits and compensation package" is somewhat vague but not exactly placeholder. Might be okay to include Benefits section with that sentence. But we could also omit Benefits if we deem it too vague. The instruction: Prefer a few substantive sections over many thin ones. So maybe we omit Benefits.
Skills: Could be covered under Required Qualifications (Microsoft Office suite, etc.) but we could have a Skills section. However we already have Required Qualifications covering skills. Might be redundant. Better to have sections: About the role (maybe Job Summary), Responsibilities (Essential Job Duties), Requirements (Required Qualifications), Preferred Qualifications, Pay, Schedule.
We need to use for each section heading. Use - for any list of duties/requirements/benefits. Use
for prose.
We must not include markdown code fences. Just raw HTML.
Let's craft:
About the role
Opportunity for a TX licensed RN residing in Texas with experience functioning as a Care Manager working with complex/intensive cases. Telephonically you will complete assessments needed for determining the types of services to provide and managing member care until discharge. The ideal candidate will have experience as a Case Manager within a managed care organization (MCO) like Molina, but RNs with a strong background in complex cases are also considered.
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 a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address member needs and goals.
- Perform ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
- Promote integration of services for members including behavioral health care and long‑term services and supports (LTSS) and home and community resources to enhance continuity of care.
- Assess for medical necessity and authorize all 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 for barriers to care and provide care coordination and assistance to members to address psycho/social, 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.
- Conduct medication reconciliation as needed.
Requirements
- 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.
- 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) with an active, unrestricted license in the state of practice (Texas).
- Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job‑related travel (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 when working with diverse populations and various personalities.
- 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 adapt to change.
- Problem‑solving skills.
- Strong verbal and written communication skills.
- Microsoft Office suite proficiency (Outlook, Excel, Teams) and confidence moving between different programs to complete forms and documentation.
Preferred Qualifications
- Certified Case Manager (CCM).
- Experience working with populations that receive waiver services.
Pay
Pay range: $26.41 – $51.49 per hour. Actual compensation may vary based on geographic location, work experience, education, and/or skill level.
Schedule
Monday – Friday, 8 AM – 5 PM CST, working from home. Approximately 25‑40% estimated local travel may be required based on state/contractual requirements.
We need to ensure we didn't include any boilerplate like EEO, Equal Opportunity Employer, etc. We removed that. Also removed internal job board note.
Check for any repeated lines: we have not duplicated.
All substantive info preserved: TX licensed RN residing in Texas, telephonic assessments, managing care until discharge, ideal candidate experience as Case Manager within MCO like Molina, also consider RNs with strong background in complex cases. Hours Monday-Friday 8-5 CST working from home. Solid experience with Microsoft Office Suite (Outlook, Excel, Teams) and moving between programs. Excellent computer skills and attention to detail important to multitask between systems and talking with members on phone while entering accurate contact notes. Fast-paced position, productivity important. Job Summary: we captured in About the role? Actually we placed some of that in About the role. The Job Summary paragraph is separate: "Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care." We missed that. We need to include that somewhere. Could add a Job Summary
or incorporate into About the role. The instruction: Use for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). They gave examples but not limited to those. We can add Job Summary as a heading if we want. But we already have About the role; maybe we can merge Job Summary into About the role. However we should preserve all substantive info; we can add a
under About the role that includes the Job Summary text. Let's adjust About the role paragraph to include both the opportunity description and the Job Summary.
Let's rewrite About the role:
Opportunity for a TX licensed RN residing in Texas with experience functioning as a Care Manager working with complex/intensive cases. Telephonically you will complete assessments needed for determining the types of services to provide and managing member care until discharge. The ideal candidate will have experience as a Case Manager within a managed care organization (MCO) like Molina, but RNs with a strong background in complex cases are also considered. This role provides support for care management/care coordination long‑term services and supports (LTSS)-specific activities, collaborates with a multidisciplinary team to coordinate integrated delivery of member care across the continuum for members with high‑need potential, strives to ensure member progress toward desired outcomes, and contributes to the overarching strategy to provide quality and cost‑effective member care.
That covers.
Now ensure we didn't miss any details: "Solid experience with Microsoft Office Suite is necessary, especially with Outlook, Excel, and Teams as well as being confident in moving between different programs to complete the necessary forms and documentation." We included Microsoft Office suite proficiency (Outlook, Excel, Teams) and confidence moving between programs.
"Excellent computer skills and attention to detail are very important to multitask between systems and talking with members on the phone while entering accurate contact notes." We included attention to detail, ability to multitask, etc. Could add explicit mention of multitask between systems and talking with members while entering notes. We have ability to focus on multiple projects simultaneously, but not exactly that. Let's add a bullet under Requirements: "Ability to multitask between systems, talk with members on the phone, and enter accurate contact notes." Or incorporate into existing bullet.
We'll add a bullet: "Ability to multitask between systems, talk with members on the phone, and enter accurate contact notes."
Also "This is a fast-paced position and productivity is important." We can add a bullet: "Ability to thrive in a fast‑paced environment and maintain high productivity."
Add that.
Also "25-40% estimated local travel may be required (based upon state/contractual requirements)." Already in Schedule.
Also "In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements)." We didn't include that. It's a conditional requirement; we should include as a note. Could add bullet: "In some states, a bachelor's degree in a health‑related field may be required (depending on state/contractual requirements)."
Also "In some states, must have at least one year of experience working directly with individuals with substance use disorders."
- for any list of duties/requirements/benefits. Use
for prose. We must not include markdown code fences. Just raw HTML. Let's craft:
About the role
Opportunity for a TX licensed RN residing in Texas with experience functioning as a Care Manager working with complex/intensive cases. Telephonically you will complete assessments needed for determining the types of services to provide and managing member care until discharge. The ideal candidate will have experience as a Case Manager within a managed care organization (MCO) like Molina, but RNs with a strong background in complex cases are also considered.
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 a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address member needs and goals.
- Perform ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
- Promote integration of services for members including behavioral health care and long‑term services and supports (LTSS) and home and community resources to enhance continuity of care.
- Assess for medical necessity and authorize all 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 for barriers to care and provide care coordination and assistance to members to address psycho/social, 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.
- Conduct medication reconciliation as needed.
Requirements
- 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.
- 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) with an active, unrestricted license in the state of practice (Texas).
- Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job‑related travel (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 when working with diverse populations and various personalities.
- 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 adapt to change.
- Problem‑solving skills.
- Strong verbal and written communication skills.
- Microsoft Office suite proficiency (Outlook, Excel, Teams) and confidence moving between different programs to complete forms and documentation.
Preferred Qualifications
- Certified Case Manager (CCM).
- Experience working with populations that receive waiver services.
Pay
Pay range: $26.41 – $51.49 per hour. Actual compensation may vary based on geographic location, work experience, education, and/or skill level.
Schedule
Monday – Friday, 8 AM – 5 PM CST, working from home. Approximately 25‑40% estimated local travel may be required based on state/contractual requirements.
We need to ensure we didn't include any boilerplate like EEO, Equal Opportunity Employer, etc. We removed that. Also removed internal job board note. Check for any repeated lines: we have not duplicated. All substantive info preserved: TX licensed RN residing in Texas, telephonic assessments, managing care until discharge, ideal candidate experience as Case Manager within MCO like Molina, also consider RNs with strong background in complex cases. Hours Monday-Friday 8-5 CST working from home. Solid experience with Microsoft Office Suite (Outlook, Excel, Teams) and moving between programs. Excellent computer skills and attention to detail important to multitask between systems and talking with members on phone while entering accurate contact notes. Fast-paced position, productivity important. Job Summary: we captured in About the role? Actually we placed some of that in About the role. The Job Summary paragraph is separate: "Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care." We missed that. We need to include that somewhere. Could add aJob Summary
or incorporate into About the role. The instruction: Usefor section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). They gave examples but not limited to those. We can add Job Summary as a heading if we want. But we already have About the role; maybe we can merge Job Summary into About the role. However we should preserve all substantive info; we can add a
under About the role that includes the Job Summary text. Let's adjust About the role paragraph to include both the opportunity description and the Job Summary. Let's rewrite About the role:
Opportunity for a TX licensed RN residing in Texas with experience functioning as a Care Manager working with complex/intensive cases. Telephonically you will complete assessments needed for determining the types of services to provide and managing member care until discharge. The ideal candidate will have experience as a Case Manager within a managed care organization (MCO) like Molina, but RNs with a strong background in complex cases are also considered. This role provides support for care management/care coordination long‑term services and supports (LTSS)-specific activities, collaborates with a multidisciplinary team to coordinate integrated delivery of member care across the continuum for members with high‑need potential, strives to ensure member progress toward desired outcomes, and contributes to the overarching strategy to provide quality and cost‑effective member care.
That covers. Now ensure we didn't miss any details: "Solid experience with Microsoft Office Suite is necessary, especially with Outlook, Excel, and Teams as well as being confident in moving between different programs to complete the necessary forms and documentation." We included Microsoft Office suite proficiency (Outlook, Excel, Teams) and confidence moving between programs. "Excellent computer skills and attention to detail are very important to multitask between systems and talking with members on the phone while entering accurate contact notes." We included attention to detail, ability to multitask, etc. Could add explicit mention of multitask between systems and talking with members while entering notes. We have ability to focus on multiple projects simultaneously, but not exactly that. Let's add a bullet under Requirements: "Ability to multitask between systems, talk with members on the phone, and enter accurate contact notes." Or incorporate into existing bullet. We'll add a bullet: "Ability to multitask between systems, talk with members on the phone, and enter accurate contact notes." Also "This is a fast-paced position and productivity is important." We can add a bullet: "Ability to thrive in a fast‑paced environment and maintain high productivity." Add that. Also "25-40% estimated local travel may be required (based upon state/contractual requirements)." Already in Schedule. Also "In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements)." We didn't include that. It's a conditional requirement; we should include as a note. Could add bullet: "In some states, a bachelor's degree in a health‑related field may be required (depending on state/contractual requirements)." Also "In some states, must have at least one year of experience working directly with individuals with substance use disorders."