Talent.com
No longer accepting applications
Director, Healthcare Services; Care Management (Remote - GA)

Director, Healthcare Services; Care Management (Remote - GA)

Molina HealthcareAlpharetta, GA, United States
1 day ago
Job type
  • Full-time
  • Remote
Job description

This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia.

JOB DESCRIPTION Job Summary

Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions : utilization management, care management, behavioral health and other programs. Leads team responsible for assessing, facilitating, planning and coordinating integrated delivery of care across the continuum. Participates with senior leadership to establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

  • Directs and oversees one or more of the following key health care services functions : care management, utilization management, care transitions, long-term supports and services (LTSS), behavioral health, nurse advice line, and / or other special programs.
  • Develops, implements and / or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care coordination / care review and management.
  • Develops and promotes interdepartmental integration and collaboration to enhance clinical services.
  • Collaborates with and keeps healthcare services senior leadership informed of operational issues, staffing, resources, system and program needs and presents solutions / action plans for issues.
  • Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote a standardized enterprise-wide approach to healthcare services programs.
  • Ensures monthly auditing is occurring with appropriate follow-up.
  • Engages in clinical training activities and outcomes.
  • Develops and mentors direct reporting healthcare services leadership.
  • Local travel may be required (based upon state / contractual requirements).

Required Qualifications

  • At least 8 years health care experience, and at least 5 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.
  • At least 3 years health care management / leadership required.
  • 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 or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
  • Experience working within applicable state, federal, and third party regulations.
  • Ability to manage conflict and lead through change.
  • Operational and process improvement experience.
  • Ability to work cross-collaboratively across a highly matrixed organization.
  • Ability to prioritize and manage multiple deadlines.
  • Excellent organizational, problem-solving and critical-thinking skills.
  • Strong written and verbal communication skills.
  • Microsoft Office suite / applicable software program(s) proficiency.
  • Preferred Qualifications

  • 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.
  • To all current Molina employees : If you are interested in applying for this position, please apply through the Internal Job Board.

    Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V

    #PJHS

    Pay Range : $88,453 - $172,484 / ANNUAL

  • Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
  • Create a job alert for this search

    Director Care Management • Alpharetta, GA, United States

    Related jobs
    • Promoted
    Kentucky Licensed Care Manager

    Kentucky Licensed Care Manager

    VirtualVocationsMarietta, Georgia, United States
    Full-time
    A company is looking for a Care Manager (RN) to develop and facilitate care management activities for members with physical needs. Key Responsibilities Evaluate member needs and recommend care pla...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Senior Manager Clinical Biomarkers

    Senior Manager Clinical Biomarkers

    VirtualVocationsMarietta, Georgia, United States
    Full-time
    A company is looking for a Senior Manager of Clinical Biomarkers.Key Responsibilities Lead the development and execution of clinical biomarker plans aligned with clinical development strategy Ov...Show moreLast updated: 3 hours ago
    • Promoted
    Clinical Operations Manager

    Clinical Operations Manager

    VirtualVocationsMarietta, Georgia, United States
    Full-time
    A company is looking for a Line Manager to oversee the execution of clinical trials and manage clinical study teams.Key Responsibilities Lead the operational planning and execution of clinical tr...Show moreLast updated: 30+ days ago
    • Promoted
    Telephonic Nurse Case Manager

    Telephonic Nurse Case Manager

    AmTrust FinancialAlpharetta, GA, United States
    Full-time
    US-TX-Dallas | US-GA-Alpharetta | US-FL-Boca Raton | US-FL-Maitland.AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.To ...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    State Licensed Behavioral Health Director

    State Licensed Behavioral Health Director

    VirtualVocationsLawrenceville, Georgia, United States
    Full-time
    A company is looking for a Senior Director, Utilization Management - Behavioral Health.Key Responsibilities Lead and oversee behavioral health management within the utilization management organiz...Show moreLast updated: 11 hours ago
    • Promoted
    • New!
    Delaware Licensed Medical Director

    Delaware Licensed Medical Director

    VirtualVocationsAlpharetta, Georgia, United States
    Full-time
    A company is looking for a Medical Director for long term care.Key Responsibilities Ensure outstanding medical care and optimal health outcomes for residents Provide direct patient care while ov...Show moreLast updated: 11 hours ago
    • Promoted
    Registered Nurse Manager

    Registered Nurse Manager

    VirtualVocationsMarietta, Georgia, United States
    Full-time
    A company is looking for a Care Navigation Nurse Manager to provide strategic and operational leadership to their Care Navigation team. Key Responsibilities Oversee daily operations of the Care Na...Show moreLast updated: 30+ days ago
    • Promoted
    Med Care Manager

    Med Care Manager

    Sunrise Senior LivingDuluth, GA, US
    Full-time
    When you join Sunrise Senior Living, you will be able to use your unique skills to empower residents to live longer, healthier, and happier lives. Not only will you build meaningful relationships wi...Show moreLast updated: 1 day ago
    • Promoted
    • New!
    Registered Nurse Maternity Supervisor

    Registered Nurse Maternity Supervisor

    VirtualVocationsMarietta, Georgia, United States
    Full-time
    A company is looking for a Maternity Case Management Supervisor.Key Responsibilities : Manage the day-to-day operations of the Maternity Case Management department Oversee team caseloads and faci...Show moreLast updated: 7 hours ago
    • Promoted
    Medical Director- MD

    Medical Director- MD

    JobotCumming, GA, US
    Full-time
    Primary Care or Family Medicine Physician Needed for Adult Only Healthcare Facility in Cumming GA.This Jobot Job is hosted by : Adam Cejnowski. Are you a fit? Easy Apply now by clicking the "App...Show moreLast updated: 5 days ago
    • Promoted
    • New!
    Healthcare Industry Success Leader

    Healthcare Industry Success Leader

    VirtualVocationsMarietta, Georgia, United States
    Full-time
    A company is looking for an Industry Success Leader (HCLS).Key Responsibilities Serve as a Consulting Leader, leveraging domain expertise to improve client business outcomes Own and develop a bo...Show moreLast updated: 7 hours ago
    • Promoted
    Pennsylvania Licensed Care Manager Supervisor

    Pennsylvania Licensed Care Manager Supervisor

    VirtualVocationsAtlanta, Georgia, United States
    Full-time
    A company is looking for a Professional Care Manager, Supervisor (RN).Key Responsibilities Oversee care coordination functions for clinical staff, including supervision, coaching, and counseling ...Show moreLast updated: 1 day ago
    • Promoted
    Senior Clinical Coordinator

    Senior Clinical Coordinator

    VirtualVocationsMarietta, Georgia, United States
    Full-time
    A company is looking for a Senior Clinical Administrative Coordinator.Key Responsibilities Act as a Subject Matter Expert for team members Manage the intake of members with benefit reviews and i...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Associate Practice Manager

    Associate Practice Manager

    VirtualVocationsMarietta, Georgia, United States
    Full-time
    A company is looking for an Associate Practice Manager.Key Responsibilities Assist in overseeing administrative, care coordination, and field support teams to ensure timely and high-quality patie...Show moreLast updated: 7 hours ago
    • Promoted
    • New!
    Medical Director, US Licensed

    Medical Director, US Licensed

    VirtualVocationsLawrenceville, Georgia, United States
    Full-time
    A company is looking for a Medical Director - US Medical Lead - Evenity (Bone).Key Responsibilities Support the development and execution of US product medical strategy and lifecycle management ...Show moreLast updated: 9 hours ago
    • Promoted
    Licensed Clinical Supervisor

    Licensed Clinical Supervisor

    VirtualVocationsMarietta, Georgia, United States
    Full-time
    A company is looking for a Supervisor, Clinical Administration - Remote.Key Responsibilities Provide leadership to a team of clinicians supporting membership in multiple facets of care Guide and...Show moreLast updated: 30+ days ago
    • Promoted
    Care Management Coordinator

    Care Management Coordinator

    VirtualVocationsMarietta, Georgia, United States
    Full-time
    A company is looking for a Care Management Support Coordinator II to assist with administrative care management activities. Key Responsibilities Conduct outreach to members via phone to assist wit...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Delaware Licensed Clinical Supervisor

    Delaware Licensed Clinical Supervisor

    VirtualVocationsMarietta, Georgia, United States
    Full-time
    A company is looking for a Clinical Supervisor - LCSW - Remote.Key Responsibilities Provide clinical supervision to a minimum of six resident clinicians, including weekly group and individual sup...Show moreLast updated: 7 hours ago
    • Promoted
    Oregon Licensed Care Management Coordinator

    Oregon Licensed Care Management Coordinator

    VirtualVocationsMarietta, Georgia, United States
    Full-time
    A company is looking for a Care Management Clinical Support Coordinator who will perform duties in support of care management and integrated medical management programs.Key Responsibilities Suppo...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Clinical Service Excellence Manager

    Clinical Service Excellence Manager

    VirtualVocationsNorcross, Georgia, United States
    Full-time
    A company is looking for a Clinical Service Excellence Manager to oversee clinical processes and support Neurology programs. Key Responsibilities Oversee clinical processes and serve as the client...Show moreLast updated: 5 hours ago