Leads and supervises a multidisciplinary team of healthcare services professionals in some or all the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs. Ensures members reach desired outcomes through integrated delivery and coordination of care across the continuum, and contributes to the overarching strategy to provide quality, cost-effective member care.
Essential Job Duties
Assists in implementing health management, care management, utilization management, behavioral health, and other program activities in accordance with regulatory and contract standards and accreditation requirements.
Functions as a "hands-on" supervisor, assisting with the assessment and evaluation of systems, day-to-day operations, and operational/service efficiency.
Assists in coordinating the orientation and training of staff to ensure maximum efficiency and productivity, effective program implementation, and service excellence.
Trains and supports team members to ensure high-risk, complex members are adequately supported.
Assists with staff performance appraisals, ongoing performance monitoring, and application of protocols and guidelines.
Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing, resources, and system and program needs.
Assists with coordination and reporting of department statistics and ongoing client reports, as assigned.
Local travel may be required (based on state or contractual requirements).
Required Qualifications
At least five (5) years of healthcare experience and at least two (2) years of managed care experience in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or long-term services and supports (LTSS), or an equivalent combination of relevant education and experience.
Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification is required only if mandated by state contract, regulation, business operating model, or state board licensing requirements. If licensed, the license must be active and unrestricted in the state of practice.
Ability to manage conflict and lead through change.
Operational and process improvement experience.
Strong written and verbal communication skills.
Working knowledge of the Microsoft Office suite.
Ability to prioritize and manage multiple deadlines.
Excellent organizational, problem-solving, and critical-thinking skills.
Preferred Qualifications
Registered Nurse (RN). License must be active and unrestricted in the state of practice.
Certified Case Manager (CCM), Certified Professional in Health Care Management (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification.
Medicaid and/or Medicare population experience.
Clinical experience.
Supervisory or leadership experience.
Additional Information
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Numbers & Facts
Location
Chandler, AZ
Skills
Behavioral Healthunmatched
Business Modelunmatched
Certified Case Manager (CCM)unmatched
Clinical Competencyunmatched
Clinical Medicineunmatched
Communication Skillsunmatched
Compensation and Benefitsunmatched
Contract Requirementsunmatched
Cross-Functionalunmatched
Establish Prioritiesunmatched
Healthcareunmatched
Healthcare Managementunmatched
Healthcare Qualityunmatched
Leadershipunmatched
Licensed Clinical Social Worker (LCSW)unmatched
Licensingunmatched
Long-Term Careunmatched
Managed Careunmatched
Medicaidunmatched
Medicareunmatched
Microsoft Officeunmatched
Operational Improvementunmatched
Operations Processesunmatched
Organizational Skillsunmatched
People Managementunmatched
Performance Analysisunmatched
Performance Reviewsunmatched
Presentation/Verbal Skillsunmatched
Problem Solving Skillsunmatched
Process Improvementunmatched
Productivity Managementunmatched
Registered Nurse (RN)unmatched
Regulationsunmatched
Riskunmatched
Social Workunmatched
Staff Trainingunmatched
State Laws and Regulationsunmatched
Statisticsunmatched
Systems Analysisunmatched
Team Lead/Managerunmatched
Time Managementunmatched
Utilization Managementunmatched
Willing to Travelunmatched
Writing Skillsunmatched
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