California Registered Nurse.JOB DESCRIPTION
Job Summary
Leads and supervises multidisciplinary team of healthcare services professionals in some or all of the following functions : care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and / or other special programs. Ensures members reach desired outcomes through integrated delivery and coordination of care across the continuum, and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
- 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).
Required Qualifications
At least 5 years health care experience, and at least 2 years of managed care experienced in one or more of the following areas : care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience or equivalent combination of relevant education and experience.
- Registered Nurse (RN),
- 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.
RN Must be licensed for the state of California. California is not a compact state.
Preferred Qualifications
- 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. (hospital / acute care)
- Supervisory / leadership experience. (overseeing clinical staff for Transition of Care)
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
Pay Range : $76,425 - $149,028 / ANNUAL
- Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.