Talent.com
Director, Healthcare Services; Care Management (Remote - GA)
Director, Healthcare Services; Care Management (Remote - GA)Molina Healthcare • Decatur, GA, United States
serp_jobs.error_messages.no_longer_accepting
Director, Healthcare Services; Care Management (Remote - GA)

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

Molina Healthcare • Decatur, GA, United States
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
  • serp_jobs.filters.remote
job_description.job_card.job_description

This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia.

JOB DESCRIPTION Job Summary

Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions : utilization management, care management, behavioral health and other programs. Leads team responsible for assessing, facilitating, planning and coordinating integrated delivery of care across the continuum. Participates with senior leadership to establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

  • Directs and oversees one or more of the following key health care services functions : care management, utilization management, care transitions, long-term supports and services (LTSS), behavioral health, nurse advice line, and / or other special programs.
  • Develops, implements and / or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care coordination / care review and management.
  • Develops and promotes interdepartmental integration and collaboration to enhance clinical services.
  • Collaborates with and keeps healthcare services senior leadership informed of operational issues, staffing, resources, system and program needs and presents solutions / action plans for issues.
  • Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote a standardized enterprise-wide approach to healthcare services programs.
  • Ensures monthly auditing is occurring with appropriate follow-up.
  • Engages in clinical training activities and outcomes.
  • Develops and mentors direct reporting healthcare services leadership.
  • Local travel may be required (based upon state / contractual requirements).

Required Qualifications

  • At least 8 years health care experience, and at least 5 years of managed care experienced in one or more of the following areas : utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
  • At least 3 years health care management / leadership required.
  • Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and / or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
  • Experience working within applicable state, federal, and third party regulations.
  • Ability to manage conflict and lead through change.
  • Operational and process improvement experience.
  • Ability to work cross-collaboratively across a highly matrixed organization.
  • Ability to prioritize and manage multiple deadlines.
  • Excellent organizational, problem-solving and critical-thinking skills.
  • Strong written and verbal communication skills.
  • Microsoft Office suite / applicable software program(s) proficiency.
  • Preferred Qualifications

  • Registered Nurse (RN). License must be active and unrestricted in state of practice.
  • Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification.
  • Medicaid / Medicare population experience.
  • Clinical experience.
  • To all current Molina employees : If you are interested in applying for this position, please apply through the Internal Job Board.

    Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V

    #PJHS

    Pay Range : $88,453 - $172,484 / ANNUAL

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

    Director Care Management • Decatur, GA, United States

    Job_description.internal_linking.related_jobs
    Florida Licensed Behavioral Health Director

    Florida Licensed Behavioral Health Director

    VirtualVocations • Decatur, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Senior Director, Behavioral Health Utilization Management.Key Responsibilities Leads and directs the behavioral health utilization management team to ensure appropriate...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Director of Clinical Operations

    Director of Clinical Operations

    VirtualVocations • Norcross, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director of Clinical Services Operations.Key Responsibilities Lead day-to-day operations ensuring compliance with contracts and regulations Develop and implement proce...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Medical Director - Colorado Licensed

    Medical Director - Colorado Licensed

    VirtualVocations • Atlanta, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Medical Director - Post-Acute Care Management - Care Transitions.Key Responsibilities Provide daily utilization oversight and communication with network physicians and ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Director, Clinical Systems

    Director, Clinical Systems

    Molina Healthcare • ATLANTA, US
    serp_jobs.job_card.full_time
    Leads and directs a team supporting clinical systems.Responsible for provision of product ownership of clinical applications including design, development, implementation, and oversight of technolo...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Healthcare Sales Director

    Healthcare Sales Director

    VirtualVocations • Lawrenceville, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Sales Director in the Healthcare Industry for remote work.Key Responsibilities Build and maintain relationships with midsize to enterprise-level clients in the Healthca...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Arizona Licensed Clinical Systems Director

    Arizona Licensed Clinical Systems Director

    VirtualVocations • Marietta, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director, Clinical Systems.Key Responsibilities Lead and direct a team supporting clinical systems and oversee the system development lifecycle (SDLC) Manage the creat...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Director of Clinical Strategy

    Director of Clinical Strategy

    VirtualVocations • Norcross, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director, Clinical Strategy & Operations.Key Responsibilities Lead and develop a high-performing team focused on forecasting, scheduling, and productivity optimization ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Director - Critical Care

    Director - Critical Care

    Piedmont Healthcare • Cartersville, GA, US
    serp_jobs.job_card.full_time
    JOB PURPOSE : Under the Direction of the Vice President of Patient Services / Chief Nursing Officer has administrative and operational responsibility for assigned departments, including management of ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Director of Care Operations

    Director of Care Operations

    VirtualVocations • Atlanta, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director of Care Operations.Key Responsibilities Oversee day-to-day operations of the Enhanced Care Management program to meet delivery targets Grow and manage a multi...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Healthcare Strategy Director

    Healthcare Strategy Director

    VirtualVocations • Norcross, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director of Corporate Strategy.Key Responsibilities Lead the formulation and execution of corporate strategy initiatives and conduct market analysis Develop and implem...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Executive Director of Consumer Access

    Executive Director of Consumer Access

    VirtualVocations • Lawrenceville, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for an Executive Director of Consumer Access Remote.Key Responsibilities Provide strategic oversight to revenue cycle functions and ensure compliance with regulatory requirem...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Director - Medical Surgical

    Director - Medical Surgical

    Piedmont Atlanta Hospital • Northlake, GA, US
    serp_jobs.job_card.full_time
    Description : This position supports Piedmont Atlanta Hospital.JOB PURPOSE : The Director Medical Surgical Services is responsible for providing effective leadership to manage the clinical and admini...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Senior Director of Managed Care

    Senior Director of Managed Care

    VirtualVocations • Decatur, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Senior Director, Managed Care Accounts (Payers).Key Responsibilities Lead the national account team focused on payers, PBMs, and health plans to secure optimal product ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Director of Strategic Initiatives

    Director of Strategic Initiatives

    VirtualVocations • Norcross, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director of Global Industries and Solutions GTM Readiness Strategic Initiatives Project Management. Key Responsibilities Oversee a team focused on strategic initiatives,...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Senior Director of Clinical Operations

    Senior Director of Clinical Operations

    VirtualVocations • Norcross, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Senior Director, Clinical Operations.Key Responsibilities Ensure compliance with regulatory requirements and implement risk-based quality management across clinical stu...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Director of UM Innovation

    Director of UM Innovation

    VirtualVocations • Lawrenceville, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Lead Director of UM Innovation Delivery.Key Responsibilities Lead and manage strategic projects and programs from initiation to completion, ensuring on-time delivery an...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Director, Product

    Director, Product

    Zelis Healthcare, LLC • Atlanta, GA, United States
    serp_jobs.job_card.full_time
    Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers.We serve more than 750 payers, including the top five national health plans, regional hea...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Healthcare Compliance Director

    Healthcare Compliance Director

    VirtualVocations • Marietta, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director of Compliance - Remote.Key Responsibilities Identify and mitigate organizational risks across various domains including clinical and operational Oversee compl...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Healthcare Strategic Initiatives Lead

    Healthcare Strategic Initiatives Lead

    VirtualVocations • Norcross, Georgia, United States
    serp_jobs.job_card.full_time
    A company is looking for a Global Industries and Solutions Strategic Initiatives Lead (HCLS).Key Responsibilities Drive end-to-end initiative success across the organization in Healthcare / Life Sc...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Residence Director

    Residence Director

    InsideHigherEd • Lawrenceville, Georgia, United States
    serp_jobs.job_card.full_time +1
    Since our founding in 2005, Georgia Gwinnett College (GGC) has been dedicated to providing an exceptional educational experience to our students. At GGC, we believe that our students' success is our...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted