Clinical Lead: Care Management & Transitions

Molina Healthcare; Orlando (FL); Presencial; USD 40 000 - 78 000; Tempo integral

Resumo da oferta

Molina Healthcare is seeking a nurse-led clinical support professional in Orlando to provide lead level support to the healthcare services team across care management, utilization management, care transitions, LTSS and behavioral health, coordinating integrated member care.

You will collaborate with multidisciplinary staff to ensure member progress toward outcomes, monitor workload, support training, and help maintain program compliance.

Qualificações

• At least 4 years experience in health care, and at least 2 years of managed care experience in one or more areas (UM, CM, transitions, LTSS, behavioral health).
• Clinical licensure and/or certification required only if state contract requires it; if licensed, active and unrestricted in state of practice.
• Demonstrated knowledge of community resources.
• Proactive and detail-oriented.
• Ability to work across diverse settings and with diverse populations.
• Independent work with minimal supervision and self-motivation.
• Excellent verbal and written communication.
• Proficiency with Microsoft Office suite.

Responsabilidades

• Devises/implements delegation assignment strategies and coordinates healthcare services processes.
• Resolves day-to-day issues and escalates to leadership as needed.
• Assists in training healthcare services staff according to policies.
• Maintains a minimal caseload to support guidelines.
• Collaborates with leadership on operational issues and program needs.
• Acts as a subject matter expert and provides guidance to staff.
• Monitors staff workload for adherence to policies and guidelines.
• Participates in auditing to identify opportunities for quality and compliance improvements.
• Shares performance feedback with staff and assists with corrective action.
• Supports daily reconciliation reports and ensures compliance elements are remediated.

Conhecimentos

Attention to detail

Independent work

Communication skills

Time management

Problem-solving

Verbal communication

Written communication

Microsoft Office

Ferramentas

Microsoft Office

Descrição da oferta de emprego

Molina Healthcare is seeking a nurse-led clinical support professional in Orlando to provide lead level support to the healthcare services team across care management, utilization management, care transitions, LTSS and behavioral health, coordinating integrated member care.

You will collaborate with multidisciplinary staff to ensure member progress toward outcomes, monitor workload, support training, and help maintain program compliance.