Supervisor, Healthcare Services
About The Position
The Supervisor, Healthcare Services 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. The supervisor helps members achieve desired outcomes through integrated care coordination across the continuum and contributes to strategies for delivering quality, cost-effective member care. This is a hands-on leadership role responsible for team performance, daily operations, staffing, service levels, customer satisfaction, and compliance with regulatory, contractual, and accreditation standards. The supervisor supports high-risk and complex members, monitors healthcare services performance and protocols, promotes collaboration across teams, and identifies opportunities to improve care delivery 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.
- Credential as an 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 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 and ensure 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.
- Assist with implementing healthcare services programs 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.
- 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 improve continuity of care.
- Oversee interdisciplinary care team (ICT) meetings.
- Analyze and report statistics related to care access, plan utilization, staff productivity, cost-effective service utilization, targeted member populations, and triage activities.
- Ensure staff quality audit reviews are completed; evaluate services and outcomes and recommend program and staff-development improvements 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 operational processes.
- Hire, train, develop, and manage the team; ensure accountability for team performance and department-specific goals.
Benefits
- Competitive benefits and compensation package.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
