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Manager, Healthcare Services (RN) Registered Nurse ( California )
Manager, Healthcare Services (RN) Registered Nurse ( California )Molina Healthcare • Sacramento, CA, United States
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Manager, Healthcare Services (RN) Registered Nurse ( California )

Manager, Healthcare Services (RN) Registered Nurse ( California )

Molina Healthcare • Sacramento, CA, United States
21 days ago
Job type
  • Full-time
Job description

California resident preferred.

JOB DESCRIPTION

Job Summary

Leads and manages 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

  • Responsible for leading and managing performance of one or more of the following activities : care review, care management, transition of care, health management, behavioral health, long-term services and supports (LTSS), and / or member assessment.
  • Facilitates integrated, proactive healthcare services management - ensuring compliance with state and federal regulatory and accrediting standards and implementation of the Molina clinical model.
  • Manages and evaluates team member performance, provides coaching, employee development and recognition, ensures ongoing appropriate staff training, and has responsibility for selection, orientation and mentoring of new staff.
  • Performs and promotes interdepartmental / multidisciplinary integration and collaboration to enhance continuity of care.
  • Oversees interdisciplinary care team (ICT) meetings.
  • Functions as hands-on manager responsible for supervision and coordination of daily integrated healthcare service activities.
  • Ensures adequate staffing and service levels and maintains customer satisfaction by implementing and monitoring staff productivity and other performance indicators.
  • Collates and reports on care access and monitoring statistics including plan utilization, staff productivity, cost-effective utilization of services, management of targeted member population, and triage activities.
  • Ensures completion of staff quality audit reviews; evaluates services provided, outcomes achieved and recommends enhancements / improvements for programs and staff development to ensure consistent cost-effectiveness and compliance with all state and federal regulations and guidelines.
  • Maintains professional relationships with provider community, internal and external customers, and state agencies as appropriate, while identifying opportunities for improvement.
  • Local travel may be required (based upon state / contractual requirements).

Required Qualifications

  • At least 7 years experience in health care, and at least 3 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.
  • At least 1 year of health care management leadership experience.
  • Registered Nurse (RN). License must be active and unrestricted in state of practice.
  • Experience working within applicable state, federal, and third party regulations.
  • Demonstrated knowledge of community resources.
  • Proactive and detail-oriented.
  • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
  • Ability to work independently, with minimal supervision and demonstrate self-motivation.
  • Responsive in all forms of communication, and ability to remain calm in high-pressure situations.
  • Ability to develop and maintain professional relationships.
  • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
  • Excellent problem-solving and critical-thinking skills.
  • Excellent verbal and written communication skills.
  • Microsoft Office suite / applicable software program(s) proficiency.
  • 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.
  • Work Schedule : California Pacific Time Zone, daytime business hours. Candidates who do not live in CA must work Pacific hours permanently.

    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 : $84,067 - $163,931 / ANNUAL

    Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.

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    Registered Nurse Rn • Sacramento, CA, United States

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