Supervisor, Healthcare Services (CA License)

Molina Healthcare • Long Beach, CA

8h

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/or other special programs. The role ensures members achieve desired outcomes through integrated delivery and coordination of care across the continuum, contributing to the overarching strategy for quality and cost-effective member care. This position assists in implementing health management, care management, utilization management, behavioral health, and other program activities in accordance with regulatory, contract standards, and accreditation compliance. It functions as a “hands-on” supervisor, assisting with assessing and evaluating systems, day-to-day operations, and efficiency of operations/services.

Requirements

• At least 5 years health care experience, and at least 2 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
• 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 and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
• Ability to manage conflict and lead through change.
• Operational and process improvement experience.
• Strong written and verbal communication skills.
• Working knowledge of Microsoft Office suite.
• Ability to prioritize and manage multiple deadlines.
• Excellent organizational, problem-solving and critical-thinking skills.

Nice To Haves

• CA Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification.
• Medicaid/Medicare population experience.
• Clinical experience.
• Supervisory/leadership experience.
• MCG experience.

Responsibilities

• Assists in implementing health management, care management, utilization management, behavioral health and other program activities in accordance with regulatory, contract standards and accreditation compliance.
• Functions as a “hands-on” supervisor, assisting with assessing and evaluation of systems, day-to-day operations and efficiency of operations/services.
• Assists in the coordination of orienting and training staff to ensure maximum efficiency and productivity, program implementation, and service excellence.
• Trains and supports team members to ensure high-risk, complex members are adequately supported.
• Assists with staff performance appraisals, ongoing monitoring of performance, and application of protocols and guidelines.
• Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing, resources, system and program needs.
• Assists with coordination and reporting of department statistics and ongoing client reports, as assigned.
• Local travel may be required (based upon state/contractual requirements).

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees