Clinical Services Lead: Care Management & Transitions

Molina Healthcare, Inc.; Waltham (MA); Vor Ort; USD 90.000 - 120.000; Vollzeit

Zusammenfassung

Molina Healthcare is seeking a lead-level clinical support professional to back the healthcare services team across care management, utilization management, care transitions, LTSS and behavioral health. You will collaborate with multidisciplinary teams to ensure integrated member care and outcomes.

Ideal candidates have 4+ years in health care and 2+ years in managed care, active licensure, and strong communication and problem-solving skills.

Qualifikationen

• At least 4 years experience in health care.
• 2+ years in managed care within utilization/care management, LTSS, or behavioral health.
• Active licensure: RN/LVN/LPN/LCSW/LMFT/LPCC/LMSW as required by state.
• Strong communication and problem-solving abilities.
• Ability to work independently with minimal supervision.
• Excellent time-management and prioritization skills.
• Proactive, detail-oriented and capable of handling multiple tasks.
• Maintain confidentiality and professional relationships.

Aufgaben

• Provide lead-level support to healthcare services staff and coordinate activities.
• Resolve day-to-day issues and escalate to leadership as needed.
• Assist in training healthcare services staff per policy.
• Maintain a minimal caseload and support others with caseloads.
• Collaborate with leadership on operational and program needs.
• Act as subject matter expert and provide education to staff.
• Monitor workload and adherence to policies and guidelines.
• Participate in auditing and quality improvement activities.

Kenntnisse

Healthcare experience

Managed care

Communication skills

Detail oriented

Time management

Independent work

Multitasking

Problem solving

MS Office

Confidentiality

Ausbildung

RN/LPN/LCSW/LMFT/LPCC/LMSW licensure

RN/LPN/LCSW/LMFT/LPCC/LMSW licensure (active)

CCM/CPHM/CPHQ certification (preferred)

Tools

MS Office

Jobbeschreibung

Molina Healthcare is seeking a lead-level clinical support professional to back the healthcare services team across care management, utilization management, care transitions, LTSS and behavioral health. You will collaborate with multidisciplinary teams to ensure integrated member care and outcomes.

Ideal candidates have 4+ years in health care and 2+ years in managed care, active licensure, and strong communication and problem-solving skills.