Director, Healthcare Utilization & Services (Remote WA)

Molina Talent Acquisition; Washington; À distance; USD 120 000 - 165 000; Plein temps

Résumé du poste

Molina Healthcare seeks an experienced healthcare services leader to oversee utilization management, care management and behavioral health programs for Washington state, aligning with Molina's clinical model and regulatory standards.

The role develops standardized protocols, promotes cross-department collaboration, ensures staffing, and monitors performance metrics to drive cost-effective, high-quality care delivery while supporting PST hours.

Qualifications

• At least 8 years of health care experience with managed care exposure.
• At least 3 years of management/leadership experience.
• Clinical licensure and/or certification required depending on state mandates.
• Strong customer service and member-centric focus.

Responsabilités

• Oversees team performance for health services functions (utilization management, care management, behavioral health).
• Facilitates integrated care management with adherence to regulatory standards.
• Develops and monitors standardized protocols for clinical and non-clinical activities.
• Promotes interdepartmental integration to enhance clinical services.
• Ensures staffing adequacy, monitors productivity and performance indicators.
• Oversees program activities in accordance with contracts and accreditation.

Connaissances

Strong customer service skills

Excellent written and verbal in/from

Collaboration across matrixed orgs

Organizational and problem-solving

Prioritize multiple deadlines

Formation

Nursing licensure (RN/LPN/LVN) or related licenses

Outils

Microsoft Office

Description du poste

Molina Healthcare seeks an experienced healthcare services leader to oversee utilization management, care management and behavioral health programs for Washington state, aligning with Molina's clinical model and regulatory standards.

The role develops standardized protocols, promotes cross-department collaboration, ensures staffing, and monitors performance metrics to drive cost-effective, high-quality care delivery while supporting PST hours.