Supervisor, Healthcare Services

Molina Healthcare•Long Beach, CA

About The Position

The Supervisor, Healthcare Services leads and supervises a multidisciplinary healthcare services team in functions such as care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and special programs. The role coordinates care across the continuum to support member outcomes and contributes to strategies for quality, cost-effective care. This is a hands-on leadership role responsible for team performance, day-to-day operations, staffing, service levels, regulatory and accreditation compliance, and customer satisfaction. The supervisor supports high-risk and complex members, oversees performance monitoring and interdisciplinary care team meetings, and collaborates with senior leadership and other departments to improve continuity and delivery of care. 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 may qualify.
Must hold one of the listed credentials: RN, LVN, LPN, LCSW, LMFT, LPCC, or 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 adapt work style, including working with diverse populations, 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 held 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 the Molina clinical model.
Assess systems, day-to-day operations, and the efficiency of services and care delivery.
Ensure adequate staffing and service levels, and monitor staff productivity and other performance indicators to maintain customer satisfaction.
Help implement healthcare services and program activities in accordance with regulatory, contractual, and accreditation requirements.
Ensure member care and services meet Molina's customer service standards, with adequate support for high-risk and complex members.
Oversee ongoing monitoring of healthcare services performance, protocols, and guidelines.
Keep senior healthcare services leadership informed of operational issues, staffing, resources, systems, and program needs.
Promote interdisciplinary and interdepartmental collaboration to enhance continuity of care.
Oversee interdisciplinary care team (ICT) meetings.
Analyze and report on 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 enhancements 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, and remain accountable for team performance and department goals.
Travel locally when required by state or contractual requirements.