Supervisor, Healthcare Services

Molina Healthcare•Long Beach, CA

About The Position

The Supervisor, Healthcare Services leads and supervises a multidisciplinary team working in one or more healthcare services areas, including care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and special programs. The role supports members in reaching desired outcomes through integrated care coordination across the continuum and contributes to strategies for providing quality, cost-effective care. The supervisor provides hands-on operational leadership, supports regulatory and accreditation compliance, monitors staffing, service levels and performance, and promotes collaboration across departments and care teams. The role also develops staff, oversees program activities and quality reviews, and maintains relationships with providers, customers and state agencies. 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.
Qualifying professional credential: Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (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 within 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.
Registered Nurse (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, such as care management, utilization management, transitions of care, behavioral health, LTSS or special programs.
Facilitate integrated, proactive healthcare services management in compliance with state and federal regulations, accrediting standards and the Molina clinical model.
Assist with assessing and evaluating 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.
Help implement 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.
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 improve continuity of care.
Oversee interdisciplinary care team (ICT) meetings.
Analyze and report statistics on care access and monitoring, including 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 or staff-development improvements 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 be accountable for team performance and department-specific goals.
Travel locally when required by state or contractual requirements.