Behavioral Health Program Director, Healthcare Services (Kentucky)

Molina Healthcare; Long Beach (CA); Remote; USD 80,000 - 100,000; Full time

Job summary

An established industry player is seeking a dynamic leader for their Healthcare Services team. This role involves managing clinical programs and ensuring compliance with healthcare regulations while fostering collaboration among multidisciplinary teams. The ideal candidate will have extensive experience in managed healthcare and a strong educational background in healthcare-related fields. With the flexibility of remote work, this position offers the opportunity to make a significant impact on patient care and operational excellence. If you are passionate about improving healthcare delivery and have the skills to lead a dedicated team, this is the perfect opportunity for you.

Qualifications

• 7+ years of managed healthcare experience with line management responsibility.
• Experience in clinical operations and regulatory compliance.

Responsibilities

• Manage healthcare services clinical programs and supervise Program Managers.
• Develop business strategies and facilitate collaboration across units.

Skills

Healthcare Services Management

Clinical Operations

Regulatory Compliance

Business Strategy Development

Consultative Skills

Education

Bachelor's Degree in Healthcare-related field

Master's Degree in Business or Social Work

Job description

JOB DESCRIPTION

Job Summary

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

Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

KNOWLEDGE/SKILLS/ABILITIES

• Manages one or more Healthcare Services clinical programs using staff and matrixed resources with oversight from AVP and VP as needed.
• May supervise one or more Program Managers.
• Serves as industry Subject Matter Expert in the functional area and leads programs to meet critical needs.
• Escalates gaps and barriers in implementation and compliance to AVP, VP and senior management.
• Consultative role, develops business case methodologies for programs, develops and coordinates implementation of business strategy.
• Collaborates and facilitates activities with other units at corporate and Molina Plans.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree in Healthcare-related field (equivalent combination of education and experience will be considered in lieu of Bachelor's Degree).

Required Experience

• 7+ years managed healthcare experience with line management responsibility including clinical operations.
• Experience working within applicable state, federal, and third-party regulations.

Required License, Certification, Association

If licensed, license must be active, unrestricted and in good standing.

Preferred Education

Bachelor's Degree in Nursing or a master’s degree in Business, Social Work or other healthcare related field.

Preferred Experience

• 10+ years managed care experience
• Operational and process improvement experience

Preferred License, Certification, Association

• Independently licensed behavioral health professional
• Active, unrestricted State Registered Nursing (RN) license in good standing.
• Utilization Management Certification (CPHM) Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification