Director, Inpatient Utilization & Care Management (Remote CA)

Jobtome; Bakersfield (CA); Remote; USD 102,000 - 198,000; Full time

Job summary

Molina Healthcare in California is seeking a senior healthcare services leader to direct multidisciplinary teams across utilization management, care management, and behavioral health. The role focuses on coordinating integrated care delivery, driving cost-effective member care, and collaborating with senior leadership on strategic plans.

The position requires active clinical licensure where applicable, extensive IPA delegation experience, and the ability to lead in a large, matrixed

Qualifications

• 8+ years in healthcare, with 5+ years in managed care (utilization/care management, LTSS, behavioral health)
• 3+ years in healthcare management/leadership
• Active clinical licensure where required by state contract or regulations
• Experience with state, federal, and third-party regulations
• Ability to lead through change and manage conflicts
• Strong written and verbal communication and organizational skills

Responsibilities

• Directs one or more healthcare services functions (care management, utilization management, LTSS, behavioral health, nurse advice line).
• Develops and monitors standardized protocols to enable integrated care coordination and review.
• Promotes interdepartmental collaboration to enhance clinical services.
• Keeps senior leadership informed on operational issues and presents solutions.
• Leads committees and multidisciplinary teams to standardize enterprise-wide programs.
• Ensures monthly auditing with appropriate follow-up.
• Engages in clinical training and mentors healthcare services leadership.
• Local travel may be required as per state contracts.

Skills

Healthcare leadership

Conflict management

Cross-functional collaboration

Organizational skills

Written and verbal communication

Problem solving

Education

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

Tools

Microsoft Office

Job description

Molina Healthcare in California is seeking a senior healthcare services leader to direct multidisciplinary teams across utilization management, care management, and behavioral health. The role focuses on coordinating integrated care delivery, driving cost-effective member care, and collaborating with senior leadership on strategic plans.

The position requires active clinical licensure where applicable, extensive IPA delegation experience, and the ability to lead in a large, matrixed