Clinical Lead - Care Management & Transitions

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

Job summary

Molina Healthcare is seeking a lead level clinical support professional to guide care management, utilization management, transitions, LTSS, and behavioral health initiatives, coordinating with multidisciplinary teams to improve outcomes and cost-effective member care.

The role requires strong communication, independent work, and a proactive approach to ensure adherence to policies, processes, and quality standards across departments, with local travel as needed.

Qualifications

• 4+ years in health care and 2+ years in managed care in one or more listed areas.
• RN/LVN/LPN or related licensure may be required depending on state contract and mandates.
• Demonstrated knowledge of community resources and care coordination.
• Proactive, detail-oriented, and able to work with diverse populations.
• Ability to work independently with minimal supervision and good self-motivation.
• Strong verbal and written communication skills; proficient with Microsoft Office.

Responsibilities

• Provides lead level clinical support to healthcare services teams and coordinates activities.
• Resolves day-to-day issues and communicates escalations to leadership.
• Assists in training healthcare staff per department standards and procedures.
• Maintains an appropriate caseload and supports staff with ongoing member care.
• Collaborates with leadership to address operational issues and program needs.

Skills

Healthcare experience

Managed care experience

Community resources knowledge

Detail-oriented

Independent worker

Communication skills

Time management

Education

RN, LVN, LPN, LCSW, LMFT, LPCC, LMSW (licensure as applicable)

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a lead level clinical support professional to guide care management, utilization management, transitions, LTSS, and behavioral health initiatives, coordinating with multidisciplinary teams to improve outcomes and cost-effective member care.

The role requires strong communication, independent work, and a proactive approach to ensure adherence to policies, processes, and quality standards across departments, with local travel as needed.