Now Hiring: Program Director - Crisis Stabilization Center Location: Blauvelt, NY Salary: $95,000 - $103,000 annually Schedule: Full-time Healthcare staff can work anywhere The BEST work with US! At Samaritan Daytop Village , a nationally-recognized comprehensive Health & Human Services agency with over 60 programs across New York City and the greater NY area, we serve over 33,000 New Yorkers annually in your neighborhoods and communities - our success depends upon the talent we hire. The Role Reporting to the Vice President, the Program Director is responsible for the overall clinical management and administrative operations of the assigned Crisis Stabilization Center program(s). You'll manage staff performance, ensure high-quality clinical services, maintain safe and therapeutic environments, and uphold the agency's standards of communication between program teams and senior leadership. Key Responsibilities Supervise and monitor the environment to ensure behavioral guidelines are followed and interpersonal relationships remain positive. Monitor the quality, effectiveness, and efficiency of clinical services and the safety of the environment of care. Manage program services, improve existing treatment components, and develop new services to meet client needs. Assist in developing, implementing, and deploying agency policy and procedures. Provide clinical and administrative supervision to program staff. Oversee hiring, training, appraisal, discipline (and possible termination) of subordinate staff. Provide administrative supervision for facility operations; ensure a safe and secure environment of care. Ensure clinical staff maintain accurate, complete, and timely records compliant with regulatory standards and internal policy. Ensure that all program staff uphold the agency's Code of Conduct/Ethics and comply with all relevant federal, state, and local laws and regulations (including 42 CFR confidentiality and HIPAA). Who You Are (Qualifications) Master's Degree in Social Work, Mental Health Counseling, or Psychology. 4-6 years of experience in substance use and/or mental health treatment and at least 3-5 years of administrative/supervisory experience in addiction/mental health settings. One of the following: OASAS CASAC (Advanced or Master Level) if not a licensed NYSED Qualified Health Professional (QHP). OASAS Clinical Supervision Foundations I & II (30 hours) required within 1 year of hire for Advanced/Master CASACs. OR a licensed NYSED QHP (e.g., LMSW, LMHC, LCSW, Psychologist) with the required years of experience. Knowledge of evidence-based treatments, managed care principles, and behavioral practices. Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and EHR systems. SIFI (Seminar in Field Instruction) preferred (or willingness to obtain within one year if Social Worker). Knowledgeable about federal, state, and local regulations governing substance abuse treatment programs. Why Join Us? Lead high-impact clinical programs in a mission-driven organization. Shape services that support individuals in crisis and create meaningful change in communities. Work in a respected agency with a collaborative culture and opportunities for professional growth. Ready to lead? Apply online or share with someone who fits this leadership role!
10/25/2025
Full time
Now Hiring: Program Director - Crisis Stabilization Center Location: Blauvelt, NY Salary: $95,000 - $103,000 annually Schedule: Full-time Healthcare staff can work anywhere The BEST work with US! At Samaritan Daytop Village , a nationally-recognized comprehensive Health & Human Services agency with over 60 programs across New York City and the greater NY area, we serve over 33,000 New Yorkers annually in your neighborhoods and communities - our success depends upon the talent we hire. The Role Reporting to the Vice President, the Program Director is responsible for the overall clinical management and administrative operations of the assigned Crisis Stabilization Center program(s). You'll manage staff performance, ensure high-quality clinical services, maintain safe and therapeutic environments, and uphold the agency's standards of communication between program teams and senior leadership. Key Responsibilities Supervise and monitor the environment to ensure behavioral guidelines are followed and interpersonal relationships remain positive. Monitor the quality, effectiveness, and efficiency of clinical services and the safety of the environment of care. Manage program services, improve existing treatment components, and develop new services to meet client needs. Assist in developing, implementing, and deploying agency policy and procedures. Provide clinical and administrative supervision to program staff. Oversee hiring, training, appraisal, discipline (and possible termination) of subordinate staff. Provide administrative supervision for facility operations; ensure a safe and secure environment of care. Ensure clinical staff maintain accurate, complete, and timely records compliant with regulatory standards and internal policy. Ensure that all program staff uphold the agency's Code of Conduct/Ethics and comply with all relevant federal, state, and local laws and regulations (including 42 CFR confidentiality and HIPAA). Who You Are (Qualifications) Master's Degree in Social Work, Mental Health Counseling, or Psychology. 4-6 years of experience in substance use and/or mental health treatment and at least 3-5 years of administrative/supervisory experience in addiction/mental health settings. One of the following: OASAS CASAC (Advanced or Master Level) if not a licensed NYSED Qualified Health Professional (QHP). OASAS Clinical Supervision Foundations I & II (30 hours) required within 1 year of hire for Advanced/Master CASACs. OR a licensed NYSED QHP (e.g., LMSW, LMHC, LCSW, Psychologist) with the required years of experience. Knowledge of evidence-based treatments, managed care principles, and behavioral practices. Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and EHR systems. SIFI (Seminar in Field Instruction) preferred (or willingness to obtain within one year if Social Worker). Knowledgeable about federal, state, and local regulations governing substance abuse treatment programs. Why Join Us? Lead high-impact clinical programs in a mission-driven organization. Shape services that support individuals in crisis and create meaningful change in communities. Work in a respected agency with a collaborative culture and opportunities for professional growth. Ready to lead? Apply online or share with someone who fits this leadership role!
This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia. This position will require RN Licensure. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
10/06/2025
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. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
10/06/2025
Full time
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
10/06/2025
Full time
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
10/06/2025
Full time
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
10/06/2025
Full time
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
10/06/2025
Full time
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia. This position will require RN Licensure. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
10/06/2025
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. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia. This position will require RN Licensure. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
10/06/2025
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. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia. This position will require RN Licensure. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
10/06/2025
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. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia. This position will require RN Licensure. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
10/06/2025
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. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Required Preferred Job Industries Healthcare
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
10/06/2025
Full time
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
10/06/2025
Full time
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
10/06/2025
Full time
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
10/06/2025
Full time
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
10/06/2025
Full time
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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia. This position will require RN Licensure. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
10/06/2025
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. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia. This position will require RN Licensure. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
10/06/2025
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. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia. This position will require RN Licensure. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
10/06/2025
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. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia. This position will require RN Licensure. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
10/06/2025
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. 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 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.