Supervisor, Healthcare Services

Molina Healthcare•Fort Lauderdale, FL

3d•$66,456 - $129,590

About The Position

The Supervisor, Healthcare Services leads and supervises a multidisciplinary team of healthcare services professionals in functions that may include care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and special programs. The role helps members achieve desired outcomes through integrated care coordination across the continuum and contributes to strategies for quality, cost-effective member care. The supervisor oversees team performance, service delivery, staffing, productivity, and compliance with applicable regulatory, contractual, and accreditation standards. This is a hands-on leadership position involving assessment of operations and service efficiency, monitoring of performance and care protocols, support for high-risk and complex members, and collaboration across departments. The role also hires, trains, develops, and manages staff; reports operational needs and performance information to senior leadership; and identifies opportunities to improve care delivery, quality, and operations. Local travel may be required based on state or contractual requirements.

Requirements

At least 5 years of healthcare experience, including at least 2 years of managed care experience in utilization management, care management, care transitions, behavioral health, LTSS, or special programs; an equivalent combination of relevant education and experience is also accepted.
A qualifying credential: Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW).
Clinical licensure or certification is required only when required by state contract, regulation, business operating model, or state board licensing mandates. Any license held must be active and unrestricted in the state of practice.
Strong customer service skills and a member-centric focus.
Ability to work in varied settings and adjust work style, including when working with diverse populations, different personalities, and personal situations.
Ability to prioritize and manage multiple deadlines.
Strong organizational and problem-solving skills.
Ability to collaborate cross-functionally in a highly matrixed organization.
Strong written and verbal communication skills.
Proficiency with Microsoft Office and applicable software programs.

Nice To Haves

Management or leadership experience.
Clinical experience.
RN or master's-level behavioral health licensure; any 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 another healthcare or management certification.
Experience with Medicaid or Medicare populations.

Responsibilities

Oversee team performance across one or more healthcare services functions, including care management, utilization management, care transitions, behavioral health, LTSS, and special programs.
Facilitate integrated, proactive healthcare services management in compliance with state and federal regulations, accrediting standards, and Molina's clinical model.
Assess systems, day-to-day operations, and the efficiency of services and care delivery as a hands-on leader.
Ensure adequate staffing and service levels, and maintain customer satisfaction by implementing and monitoring staff productivity and performance indicators.
Assist with implementation of healthcare services and program activities in accordance with regulatory, contractual, and accreditation requirements.
Ensure member care and services meet Molina's customer service standards.
Ensure high-risk and complex members receive adequate support.
Oversee ongoing monitoring of performance, protocols, and guidelines related to healthcare services.
Keep senior healthcare services leadership informed about operational issues, staffing, resources, systems, and program needs.
Promote interdepartmental and multidisciplinary collaboration to improve continuity of care.
Oversee interdisciplinary care team (ICT) meetings.
Analyze and report care access and monitoring statistics, including plan utilization, staff productivity, cost-effective service utilization, targeted population management, and triage activities.
Ensure staff quality audit reviews are completed; evaluate services and outcomes; and recommend program improvements and staff development to support cost-effectiveness and compliance.
Maintain professional relationships with providers, internal and external customers, and state agencies as appropriate.
Identify opportunities to improve care delivery, quality, and operations.
Hire, train, develop, and manage the team; ensure accountability for team performance and department-specific goals.
Travel locally when required by state or contractual requirements.