This position is located in both Midland and Odessa About this role: As a Social Worker with Fresenius Medical Care, you will provide psychosocial services for our dialysis clinic patients. You will w ork with the health care team to promote positive adjustment, rehabilitation, and improved quality of life for our patients. As well as support the clinic staff in understanding the emotional, psychological, and behavioral impact of chronic kidney disease on the patient and family. How you grow or advance in your career: We believe in encouraging our employees to achieve their full potential by offering opportunities for advancement. We have a social work specific career ladder ranging from pre-licensed (in states where permitted), to three potential levels of facility social work, as well as a leadership path from Social Worker to Manager, Senior Manager and Senior Director. Our culture: We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships to family members, delivering relief when natural disasters strike, or providing financial support when personal hardship hits, we take care of our people. Our focus on diversity: We have built a nurturing environment that welcomes every age, race, gender, sexual orientation, background, and cultural tradition. We have a diverse range of employee resource groups (ERGs) to encourage employees with similar interests, goals, social and cultural backgrounds, or experiences to come together for professional and personal development, discussion, activities, and peer support. Our diverse workforce and culture encourage opportunity, equity, and inclusion for all, which is a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in the lives of people living with kidney disease. If this sounds like the career and company you have been looking for, and you want to be a vital part of the future of healthcare, apply today. PRINCIPAL DUTIES AND RESPONSIBILITIES: As a member of the nephrology health care team , you will assess the patients' psychosocial status, strengths and areas of need that may affect rehabilitation and optimal treatment outcomes as part of the comprehensive patient assessment. Collaborates with the patient and health care team to identify effective interventions that will help the patient meet rehabilitation, treatment goals, and improve quality of life. Utilizes patient education programs, established social work theory and methods, social work focused interventions, and quality of life measurement instruments as part of the assessment and care planning to address barriers and meet patient treatment goals. Provides monitoring and interventions for the patient to adjust to dialysis and achieve optimal psychosocial status and quality of life. Assesses patient knowledge of kidney disease for barriers that may affect adherence to treatment. Provides supportive counseling services to patients as permitted within the scope of their clinical training and state license. Provides information and assists the team and patient with referrals to community resources (home health services, vocational rehabilitation, etc.) to facilitate optimal treatment outcomes. Maintains current knowledge regarding local vocational/educational rehabilitation programs and assist patients with referral and access to vocational rehabilitation to enable them to remain employed, become employed or receive education. Assesses patient awareness of advance directives; assists with accessing advance directive forms/information and facilitates discussion of advance directive wishes, if necessary, with the healthcare team and the patient's family/support persons. Participates in the discussion of patient DNR status in the facility to ensure patient and/or family understand and make an informed decision about their care. Reports on quality indicators related to adherence, such as missed and shortened treatments, quality of life trends, and service recovery. Works with patient, family and health care team to provide education tailored to the patient's learning style, communication barriers, and needs. Provides educational and goal directed counseling to patients who are seeking transplant. Facilitates the transplant referral process and collaborates with interdisciplinary team on transplant waitlist management. Provides ongoing education to patient/family regarding psychosocial issues related to end stage renal disease (ESRD) and all support services that are available. Reviews patient rights and responsibilities, grievance information (company and network) and other facilities policies with patient and/or the patients' representative to ensure patients' understanding of the rights and expectations of them. Provide training to clinic staff pertaining to psychosocial topics as needed. EDUCATION AND REQUIRED CREDENTIALS : Masters in Social Work Must have state required license EXPERIENCE AND SKILLS: 0 - 2 years' related experience PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Travel required (if multiple facilities or home visits, if applicable) Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. EOE, disability/veterans
10/22/2025
Full time
This position is located in both Midland and Odessa About this role: As a Social Worker with Fresenius Medical Care, you will provide psychosocial services for our dialysis clinic patients. You will w ork with the health care team to promote positive adjustment, rehabilitation, and improved quality of life for our patients. As well as support the clinic staff in understanding the emotional, psychological, and behavioral impact of chronic kidney disease on the patient and family. How you grow or advance in your career: We believe in encouraging our employees to achieve their full potential by offering opportunities for advancement. We have a social work specific career ladder ranging from pre-licensed (in states where permitted), to three potential levels of facility social work, as well as a leadership path from Social Worker to Manager, Senior Manager and Senior Director. Our culture: We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships to family members, delivering relief when natural disasters strike, or providing financial support when personal hardship hits, we take care of our people. Our focus on diversity: We have built a nurturing environment that welcomes every age, race, gender, sexual orientation, background, and cultural tradition. We have a diverse range of employee resource groups (ERGs) to encourage employees with similar interests, goals, social and cultural backgrounds, or experiences to come together for professional and personal development, discussion, activities, and peer support. Our diverse workforce and culture encourage opportunity, equity, and inclusion for all, which is a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in the lives of people living with kidney disease. If this sounds like the career and company you have been looking for, and you want to be a vital part of the future of healthcare, apply today. PRINCIPAL DUTIES AND RESPONSIBILITIES: As a member of the nephrology health care team , you will assess the patients' psychosocial status, strengths and areas of need that may affect rehabilitation and optimal treatment outcomes as part of the comprehensive patient assessment. Collaborates with the patient and health care team to identify effective interventions that will help the patient meet rehabilitation, treatment goals, and improve quality of life. Utilizes patient education programs, established social work theory and methods, social work focused interventions, and quality of life measurement instruments as part of the assessment and care planning to address barriers and meet patient treatment goals. Provides monitoring and interventions for the patient to adjust to dialysis and achieve optimal psychosocial status and quality of life. Assesses patient knowledge of kidney disease for barriers that may affect adherence to treatment. Provides supportive counseling services to patients as permitted within the scope of their clinical training and state license. Provides information and assists the team and patient with referrals to community resources (home health services, vocational rehabilitation, etc.) to facilitate optimal treatment outcomes. Maintains current knowledge regarding local vocational/educational rehabilitation programs and assist patients with referral and access to vocational rehabilitation to enable them to remain employed, become employed or receive education. Assesses patient awareness of advance directives; assists with accessing advance directive forms/information and facilitates discussion of advance directive wishes, if necessary, with the healthcare team and the patient's family/support persons. Participates in the discussion of patient DNR status in the facility to ensure patient and/or family understand and make an informed decision about their care. Reports on quality indicators related to adherence, such as missed and shortened treatments, quality of life trends, and service recovery. Works with patient, family and health care team to provide education tailored to the patient's learning style, communication barriers, and needs. Provides educational and goal directed counseling to patients who are seeking transplant. Facilitates the transplant referral process and collaborates with interdisciplinary team on transplant waitlist management. Provides ongoing education to patient/family regarding psychosocial issues related to end stage renal disease (ESRD) and all support services that are available. Reviews patient rights and responsibilities, grievance information (company and network) and other facilities policies with patient and/or the patients' representative to ensure patients' understanding of the rights and expectations of them. Provide training to clinic staff pertaining to psychosocial topics as needed. EDUCATION AND REQUIRED CREDENTIALS : Masters in Social Work Must have state required license EXPERIENCE AND SKILLS: 0 - 2 years' related experience PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Travel required (if multiple facilities or home visits, if applicable) Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. EOE, disability/veterans
Social Worker Full Time Location: Sitka, AK Schedule: Full-Time Day Shift Position Overview: A healthcare facility in Sitka, Alaska is seeking a compassionate and experienced Social Worker to join its care team. This role provides vital support to patients and families, addressing emotional, social, and practical needs across a range of healthcare settings. The ideal candidate will be a skilled communicator and advocate with a strong commitment to patient-centered care. Responsibilities: Conduct psychosocial assessments and develop individualized care plans Provide counseling, crisis intervention, and support to patients and families Coordinate discharge planning, referrals, and community resource connections Collaborate with healthcare providers to ensure comprehensive patient care Advocate for patient needs and help navigate healthcare systems Maintain accurate and timely documentation in compliance with regulations and facility policies Participate in interdisciplinary team meetings and quality improvement initiatives Qualifications: Bachelor s or Master s degree in Social Work (MSW preferred) from an accredited program Current Alaska Social Work License (or eligibility to obtain) Experience in medical or clinical social work preferred Strong knowledge of community resources, case management, and counseling techniques Excellent interpersonal, communication, and organizational skills Ability to work independently and collaboratively in a fast-paced environment Why Join Us? Work in a close-knit, supportive healthcare team Competitive salary and full benefits package Opportunities for professional development and advancement Live and work in Sitka, AK , a scenic coastal town rich in history and natural beauty For more information please send your resume directly to or call/text me at
10/08/2025
Full time
Social Worker Full Time Location: Sitka, AK Schedule: Full-Time Day Shift Position Overview: A healthcare facility in Sitka, Alaska is seeking a compassionate and experienced Social Worker to join its care team. This role provides vital support to patients and families, addressing emotional, social, and practical needs across a range of healthcare settings. The ideal candidate will be a skilled communicator and advocate with a strong commitment to patient-centered care. Responsibilities: Conduct psychosocial assessments and develop individualized care plans Provide counseling, crisis intervention, and support to patients and families Coordinate discharge planning, referrals, and community resource connections Collaborate with healthcare providers to ensure comprehensive patient care Advocate for patient needs and help navigate healthcare systems Maintain accurate and timely documentation in compliance with regulations and facility policies Participate in interdisciplinary team meetings and quality improvement initiatives Qualifications: Bachelor s or Master s degree in Social Work (MSW preferred) from an accredited program Current Alaska Social Work License (or eligibility to obtain) Experience in medical or clinical social work preferred Strong knowledge of community resources, case management, and counseling techniques Excellent interpersonal, communication, and organizational skills Ability to work independently and collaboratively in a fast-paced environment Why Join Us? Work in a close-knit, supportive healthcare team Competitive salary and full benefits package Opportunities for professional development and advancement Live and work in Sitka, AK , a scenic coastal town rich in history and natural beauty For more information please send your resume directly to or call/text me at
Social Worker Emergency Room (Full Time, Evenings or Nights) Location: Newark, DE Schedule: Full-Time Evening or Night Shifts Position Overview: A healthcare organization in Newark, Delaware is seeking a dedicated and experienced Social Worker to provide critical support in the Emergency Room setting. This full-time role focuses on addressing the psychosocial needs of patients and families during urgent and often stressful situations, ensuring access to resources and facilitating discharge planning. Responsibilities: Conduct psychosocial assessments for patients presenting in the emergency department Provide crisis intervention, counseling, and resource coordination for patients and families Collaborate closely with medical staff, case managers, and community agencies to support patient care and safe discharge Facilitate referrals to appropriate outpatient services, shelters, or support programs Assist with documentation and maintain compliance with hospital policies and regulatory requirements Participate in multidisciplinary team discussions and emergency department quality initiatives Qualifications: Bachelor s or Master s degree in Social Work (MSW preferred) from an accredited program Current Delaware Social Work License (or eligibility to obtain) Experience in emergency or acute care social work preferred Strong crisis intervention, communication, and problem-solving skills Ability to work effectively in a fast-paced, high-stress environment Flexibility to work evening or night shifts Why Join Us? Be part of a dynamic team making a difference in acute care Competitive salary and comprehensive benefits package Opportunities for growth and continuing education Work in Newark, DE , with access to vibrant urban and suburban amenities For more information please send your resume directly to or call/text me at
10/08/2025
Full time
Social Worker Emergency Room (Full Time, Evenings or Nights) Location: Newark, DE Schedule: Full-Time Evening or Night Shifts Position Overview: A healthcare organization in Newark, Delaware is seeking a dedicated and experienced Social Worker to provide critical support in the Emergency Room setting. This full-time role focuses on addressing the psychosocial needs of patients and families during urgent and often stressful situations, ensuring access to resources and facilitating discharge planning. Responsibilities: Conduct psychosocial assessments for patients presenting in the emergency department Provide crisis intervention, counseling, and resource coordination for patients and families Collaborate closely with medical staff, case managers, and community agencies to support patient care and safe discharge Facilitate referrals to appropriate outpatient services, shelters, or support programs Assist with documentation and maintain compliance with hospital policies and regulatory requirements Participate in multidisciplinary team discussions and emergency department quality initiatives Qualifications: Bachelor s or Master s degree in Social Work (MSW preferred) from an accredited program Current Delaware Social Work License (or eligibility to obtain) Experience in emergency or acute care social work preferred Strong crisis intervention, communication, and problem-solving skills Ability to work effectively in a fast-paced, high-stress environment Flexibility to work evening or night shifts Why Join Us? Be part of a dynamic team making a difference in acute care Competitive salary and comprehensive benefits package Opportunities for growth and continuing education Work in Newark, DE , with access to vibrant urban and suburban amenities For more information please send your resume directly to or call/text me at
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.
