Health services manager serp_jobs.h1.location_city

Job Opportunity

Nevada residents preferred. Candidates who do not live in Nevada must work Pacific Business Hours.

Job Summary :

Leads and manages 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 :

• Responsible for leading and managing performance of one or more of the following activities : care review, care management, utilization management (prior authorizations, inpatient / outpatient medical necessity, etc.), transition of care, health management, behavioral health, long-term services and supports (LTSS), and / or member assessment.
• Facilitates integrated, proactive healthcare services management - ensuring compliance with state and federal regulatory and accrediting standards and implementation of the Molina clinical model.
• Manages and evaluates team member performance, provides coaching, employee development and recognition, ensures ongoing appropriate staff training, and has responsibility for selection, orientation and mentoring of new staff.
• Performs and promotes interdepartmental / multidisciplinary integration and collaboration to enhance continuity of care.
• Oversees interdisciplinary care team (ICT) meetings.
• Functions as hands-on manager responsible for supervision and coordination of daily integrated healthcare service activities.
• Ensures adequate staffing and service levels and maintains customer satisfaction by implementing and monitoring staff productivity and other performance indicators.
• Collates and reports on care access and monitoring statistics including plan utilization, staff productivity, cost-effective utilization of services, management of targeted member population, and triage activities.
• Ensures completion of staff quality audit reviews; evaluates services provided, 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, internal and external customers, and state agencies as appropriate, while identifying opportunities for improvement.
• Local travel may be required (based upon state / contractual requirements).

Required Qualifications :

Preferred Qualifications :

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

Pay Range : $76,757 - $149,676 / ANNUAL