Supervisor, Healthcare Services

Molina Healthcare•Palm Beach, FL

3d•$66,456 - $129,590

About The Position

The Supervisor, Healthcare Services leads and supervises a multidisciplinary healthcare services team across one or more areas, including care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and special programs. The role supports member outcomes through integrated coordination of care across the continuum and contributes to strategies for delivering quality, cost-effective care. This is a hands-on leadership position responsible for day-to-day operations, staffing and service levels, team performance, regulatory and accreditation compliance, and alignment with Molina’s clinical model and customer service standards. The supervisor monitors operational performance, supports high-risk and complex members, promotes collaboration across departments and care teams, and identifies opportunities to improve care delivery and program effectiveness. 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 state contract, regulation, the business operating model, or state licensing board requirements. 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 style, including when 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 in 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.
Assist with assessing and evaluating systems, daily 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.
Assist in implementing healthcare services and program activities in accordance with regulatory requirements, 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 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; demonstrate accountability for team performance and department-specific goals.