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

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

Molina HealthcareAlpharetta, GA, United States
17 days 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
    Manager, Healthcare Services; Care Management (Remote - GA)

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

    Molina HealthcareLawrenceville, GA, United States
    Remote
    Full-time
    This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia.Leads and manages multidisciplinary team of healthcare services professionals i...Show moreLast updated: 17 days ago
    • Promoted
    Manager, Healthcare Services; Behavioral Health (Remote GA)

    Manager, Healthcare Services; Behavioral Health (Remote GA)

    Molina HealthcareDecatur, GA, United States
    Remote
    Full-time
    This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia.Leads and manages multidisciplinary team of healthcare services professionals i...Show moreLast updated: 17 days ago
    • Promoted
    Director of Nursing

    Director of Nursing

    Georgia Hospice CareLawrenceville, GA, US
    Full-time
    Become an RN Clinical Supervisor with Georgia Hospice Care.We are looking for impeccable leaders to join our team who are committed to creating meaningful patient experiences.As a clinical supervis...Show moreLast updated: 30+ days ago
    • Promoted
    Director, Provider Contracts (Must reside in Georgia)

    Director, Provider Contracts (Must reside in Georgia)

    Veterans StaffingRoswell, GA, US
    Full-time
    Molina Health Plan Provider Network Contracting.Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial per...Show moreLast updated: 5 days ago
    • Promoted
    Director of Healthcare

    Director of Healthcare

    SwinertonAtlanta, GA, US
    Full-time
    Overall management of the operations and administration of assigned projects with bottom line profit accountability.POSITION RESPONSIBILITIES AND DUTIES : . Able to perform all essential Senior Projec...Show moreLast updated: 30+ days ago
    • Promoted
    Home Health Director of NursingAtlanta, GA

    Home Health Director of NursingAtlanta, GA

    Abby CareAtlanta, GA, US
    Full-time
    Home Health Director Of Nursing.Our mission is to redefine care for the most vulnerable.The healthcare system is failing the underserved. We are transforming the healthcare experience for low-income...Show moreLast updated: 30+ days ago
    • Promoted
    Regional Clinical Sales Program Director

    Regional Clinical Sales Program Director

    Enhabit Home Health & HospiceLawrenceville, GA, US
    Full-time
    Regional Clinical Program Director.Territory : Athens, Lawrenceville, Gainesville and Eatonton, GA.The regional clinical program director will office from one of these home health agency locations a...Show moreLast updated: 30+ days ago
    • Promoted
    Director of Nursing - GA

    Director of Nursing - GA

    VensureRoswell, GA, US
    Full-time
    Hospice Management Leadership Opportunity.We are looking for a self-starter with a great personality to lead our clinical hospice team. If you have deep experience in hospice management and are look...Show moreLast updated: 30+ days ago
    • Promoted
    Manager, Healthcare Services; Utilization Management (Remote - GA)

    Manager, Healthcare Services; Utilization Management (Remote - GA)

    Molina HealthcareDecatur, GA, United States
    Remote
    Full-time
    This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia.Leads and manages multidisciplinary team of healthcare services professionals i...Show moreLast updated: 17 days ago
    • Promoted
    Director - Inpatient Services

    Director - Inpatient Services

    Piedmont HealthcareStockbridge, GA, US
    Full-time
    Job Purpose : Under the Direction of the Chief Nursing Officer has administrative and operational responsibility for assigned departments, including management of cost and finance, human resources, ...Show moreLast updated: 30+ days ago
    • Promoted
    Critical Care Director

    Critical Care Director

    Northside HospitalLawrenceville, GA, US
    Full-time
    Northside Hospital is award-winning, state-of-the-art, and continually growing.Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity f...Show moreLast updated: 16 days ago
    • Promoted
    Resident Care Director-RN

    Resident Care Director-RN

    Sunrise Senior LivingDunwoody, GA, United States
    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: 4 days ago
    • Promoted
    Travel Director of Rehab (DOR) in Ocilla, GA

    Travel Director of Rehab (DOR) in Ocilla, GA

    AlliedTravelCareersAtlanta, Georgia, US
    Full-time
    AlliedTravelCareers is working with All Medical Personnel to find a qualified DOR in Ocilla, Georgia, 31774!.Acts as a liaison between Occupational Therapy, Physical Therapy, Speech Therapy, Admini...Show moreLast updated: 17 days ago
    • Promoted
    Healthcare Sales Director, Adaptive Linacs- (Northeast Region)

    Healthcare Sales Director, Adaptive Linacs- (Northeast Region)

    ElektaAtlanta, GA, US
    Full-time
    Healthcare Sales Director For Adaptive Linacs.We don't just build technology.We build hope for everyone dealing with cancer. Location : Candidate must reside in the coverage territory or neighboring ...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Director, Healthcare Services; Utilization Management (Remote - GA)

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

    Molina HealthcareAlpharetta, GA, United States
    Remote
    Full-time
    This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia.This position will require RN Licensure. Leads and directs a multidisciplinary t...Show moreLast updated: 1 hour ago
    • Promoted
    Director of Home Health

    Director of Home Health

    PruittHealthAustell, GA, US
    Full-time
    Director Of Home Health Services.Home is where the heart is! That's why PruittHealth @ Home is committed to caring for our patients and residents, as well as providing our employees with a rewardin...Show moreLast updated: 22 days ago
    • Promoted
    Director, Clinical Systems

    Director, Clinical Systems

    Molina HealthcareAlpharetta, GA, United States
    Full-time
    Leads and directs a team supporting clinical systems.Responsible for provision of product ownership of clinical applications including design, development, implementation, and oversight of technolo...Show moreLast updated: 7 days ago
    • Promoted
    Director, Clinical Operations

    Director, Clinical Operations

    Molina HealthcareAtlanta, GA, United States
    Full-time
    The Director, Clinical Operations is responsible for the clinical operations within the Clinical Contact Center team.Directs all Clinical Contact Center operations. Implements direction and performa...Show moreLast updated: 17 days ago