Director of Inpatient Utilization & Care Coordination (Remote CA)

Molina Healthcare; California; Hybrid; USD 102,000 - 198,000; Full time

Job summary

Molina Healthcare seeks a senior healthcare services leader in California to oversee utilization management, care management and related programs. The role requires California RN licensure and significant IPA delegation experience.

You will guide multidisciplinary teams, develop standardized protocols and collaborate with senior leadership to deliver high-quality, cost-effective member care while navigating regulatory requirements.

Qualifications

• 8+ years in health care with 5+ years in managed care settings.
• Current active licences if required by state contract or regulation.
• Experience with regulatory requirements across state/federal programs.
• Strong leadership and change-management capabilities.

Responsibilities

• Direct and oversee care management, utilization management, and other programs.
• Develop and monitor standardized protocols for integrated care coordination.
• Promote interdepartmental collaboration to enhance clinical services.
• Communicate operational needs to senior leadership and present action plans.
• Lead committees and cross-functional work groups; ensure monthly audits.

Skills

Leadership

Cross-functional collaboration

Communication

Problem solving

Organizational skills

Education

RN/Licensed nursing

Tools

Microsoft Office

Job description

Molina Healthcare seeks a senior healthcare services leader in California to oversee utilization management, care management and related programs. The role requires California RN licensure and significant IPA delegation experience.

You will guide multidisciplinary teams, develop standardized protocols and collaborate with senior leadership to deliver high-quality, cost-effective member care while navigating regulatory requirements.