Manager, Healthcare Services Operations Support

Molina Healthcare•Long Beach, CA

25d

About The Position

Leads and manages a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.

Requirements

At least 7 years of operations or administrative experience in health care, preferably within a managed care setting, or equivalent combination of relevant education and experience.
At least 1 year of health care management/leadership experience.
Strong analytic and problem-solving abilities.
Strong organizational and time-management skills.
Ability to multi-task and meet project deadlines.
Attention to detail.
Ability to build relationships and collaborate cross-functionally.
Excellent verbal and written communication skills.
Microsoft Office suite/applicable software program(s) proficiency.

Responsibilities

Provides oversight for non-clinical operational teams that support one or more of the following healthcare services functions: care review, utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), care management, transitions of care, health management, long-term services and supports (LTSS), behavioral health, member assessment and/or other special programs.
Facilitates integrated proactive management, ensuring compliance with state, federal, regulatory and accrediting standards.
Responsible for selection, orientation, onboarding and training of new staff
Manages and evaluates team member performance and provides coaching, mentoring, employee development and recognition.
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
Performs and promotes interdepartmental/multidisciplinary integration and collaboration to enhance continuity of care and quality of services provided. .
Ensures completion of staff quality audit reviews and evaluates services provided and outcomes achieved to recommend enhancements/improvements for program and staff development, and to ensure consistency, cost-effectiveness and compliance with state/federal regulations and guidelines.
Maintains professional relationships with provider community and internal and external customers while identifying opportunities for improvement.