Supervisor, Healthcare Services

Molina Healthcare•Long Beach, FL

About The Position

Leads and supervises a multidisciplinary team of healthcare services professionals in functions such as care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and special programs. Ensures members reach desired outcomes through integrated care delivery and coordination across the continuum, while contributing to the strategy for quality and cost-effective member care. The role oversees operational performance, staffing, service levels, regulatory compliance, customer satisfaction, quality reviews, and program effectiveness. It works with internal and external partners to improve continuity of care, support high-risk and complex members, and identify process improvements. 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.
One of the following credentials: RN, LVN, LPN, LCSW, LMFT, LPCC, or LMSW. Clinical licensure or certification is required only when mandated by the state contract, regulation, business operating model, or state licensing board. 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 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 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, ensuring compliance with state and federal regulatory and accrediting standards and implementation of the Molina clinical model.
Provide hands-on leadership by assessing systems, day-to-day operations, and the efficiency of services and care delivery.
Ensure adequate staffing and service levels and maintain customer satisfaction by implementing and monitoring staff productivity and other performance indicators.
Assist with implementing healthcare services program activities in accordance with regulatory and contract standards and accreditation requirements.
Ensure member care and services align with Molina's customer service standards.
Ensure high-risk and complex members are adequately supported.
Oversee ongoing monitoring of healthcare services performance, protocols, and guidelines.
Keep senior healthcare services leadership informed about operational issues, staffing, resources, systems, and program needs.
Promote interdepartmental and multidisciplinary collaboration to enhance continuity of care.
Oversee interdisciplinary care team (ICT) meetings.
Analyze and report care access and monitoring statistics, including plan utilization, staff productivity, cost-effective utilization of services, targeted population management, and triage activities.
Ensure staff quality audit reviews are completed; evaluate services and outcomes and recommend program or staff-development improvements to promote cost-effectiveness and regulatory compliance.
Maintain professional relationships with the provider community, internal and external customers, and state agencies as appropriate.
Identify opportunities for care delivery, quality, and operational process improvements.
Hire, train, develop, and manage the team; demonstrate accountability for team performance and department-specific goals.
Travel locally when required by state or contractual requirements.