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

• Provides management and oversight for operational teams that support one or more of the following activities: care review/utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), case management, transition of care, health management and/or member assessment.
• Typically through one or more direct report supervisors, facilitates integrated, proactive management, ensuring compliance with state and federal regulatory and accrediting standards.
• Manages and evaluates team member performance; provides coaching, counseling, employee development, and recognition; ensures ongoing, appropriate staff training; and has responsibility for the selection, orientation and mentoring of new staff.
• Performs and promotes interdepartmental/ multidisciplinary integration and collaboration to enhance the continuity of care and quality of Molina services provided.
• Functions as hands-on manager responsible for supervision and coordination of daily activities.
• Ensures adequate staffing and service levels and maintains customer satisfaction by implementing and monitoring staff productivity and other performance indicators.
• Ensures completion of staff quality audit reviews. Evaluates services provided and outcomes achieved and recommends enhancements/improvements for programs and staff development to ensure consistent cost effectiveness and compliance with all state and federal regulations and guidelines.
• Maintains professional relationships with provider community and internal and external customers while identifying opportunities for improvement..

REQUIRED EDUCATION

Associate’s Degree (equivalent combination of education and relevant experience may be considered in lieu of Degree)

REQUIRED EXPERIENCE

• Min. 5 years operations or administrative experience in healthcare/ health plan industry, including 1+ years as a supervisor.
• Strong communication skills
• Strong analytic and problem solving abilities

PREFERRED EDUCATION

Associate’s or Bachelor’s Degree

PREFERRED EXPERIENCE

3+ years of healthcare or health plan supervisory experience.
Managed Care operations experience.
Prior Medical Assistant experience.

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

Please refer the Job description for details