Clinical Lead - Care Management & Transitions

Molina Healthcare; Florida; On-site; USD 40,000 - 78,000; Full time

Job summary

Molina Healthcare is seeking a clinical support lead to guide the healthcare services team across care management, utilization management and LTSS functions. The role focuses on ensuring member progress toward outcomes within a multi-disciplinary delivery model.

You will train staff, monitor workload, and collaborate with leadership to address quality, compliance, and operational needs while maintaining confidentiality and professional standards.

Qualifications

• At least 4 years experience in health care, and at least 2 years of managed care experience in UM/CM/LTSS or related areas.
• Clinical licensure/certification required ONLY if state mandates; active and unrestricted in state of practice.
• Demonstrated knowledge of community resources; ability to work independently and with diverse populations.

Responsibilities

• Provides lead level clinical support to healthcare services team and coordinates activities.
• Resolves day-to-day issues and escalates to leadership as needed.
• Assists in training healthcare services staff per standards and procedures.
• Maintains a minimal caseload to ensure adherence to guidelines and supports staff with caseloads.
• Collaborates with leadership and keeps stakeholders apprised of operational needs.
• Acts as a subject matter expert, provides support and education to staff.

Skills

Verbal communication

Written communication

Time management

Prioritization

Education

RN, LVN, LPN, LCSW, LMFT, LPCC, LMSW (license)

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a clinical support lead to guide the healthcare services team across care management, utilization management and LTSS functions. The role focuses on ensuring member progress toward outcomes within a multi-disciplinary delivery model.

You will train staff, monitor workload, and collaborate with leadership to address quality, compliance, and operational needs while maintaining confidentiality and professional standards.