Supervisor, Healthcare Services (REMOTE) - TX ONLY

Molina Healthcare•Long Beach, TX

2d•Remote

About The Position

Leads and supervises a multidisciplinary healthcare services team working in one or more areas, including care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and special programs. The supervisor supports member outcomes through integrated care coordination across the continuum and contributes to strategies for delivering quality, cost-effective care. This is a hands-on leadership role responsible for team operations, staffing, performance, quality, regulatory compliance, and service delivery. The supervisor collaborates across departments and with senior healthcare services leadership, supports high-risk and complex members, and identifies opportunities to improve care delivery and operational processes. 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.
An RN, LVN, LPN, LCSW, LMFT, LPCC, or LMSW credential. Clinical licensure or certification is required only when required by state contract, regulation, business operating model, or state 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 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 the Microsoft Office suite 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 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 regulatory and 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 maintain customer satisfaction by implementing and monitoring staff productivity and performance indicators.
Assist in implementing healthcare services programs in accordance with regulatory requirements, contract standards, and accreditation requirements.
Ensure member care and services meet Molina's customer service standards.
Ensure high-risk and complex members receive adequate support.
Monitor 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 on care access and monitoring statistics, including plan utilization, staff productivity, cost-effective service utilization, targeted member 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 regulatory 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.