** Pacific daytime business hours required. West Coast or Nevada residents preferred

Job Summary

Leads and supervises multidisciplinary team of healthcare services professionals in some or all of 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 overarching strategy to provide quality and 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, contract standards and accreditation compliance.
• Functions as a “hands-on” supervisor, assisting with assessing and evaluation of systems, day-to-day operations and efficiency of operations/services.
• Assists in the coordination of orienting and training staff to ensure maximum efficiency and productivity, 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 monitoring of performance, and application of protocols and guidelines.
• Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing, resources, system and program needs.
• Assists with coordination and reporting of department statistics and ongoing client reports, as assigned.
• Local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 5 years health care experience, and at least 2 years of managed care experience with utilization management.

management or equivalent combination of relevant education and experience.
• Registered Nurse (RN) Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in 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 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 state of practice.
• Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification.
• Medicaid/Medicare population experience.
• Clinical experience.
• Supervisory/leadership experience.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $69,779 - $110,000 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Supervisor, Healthcare Services (RN, Utilization Management)