Healthcare Services Leader: Care Management & Transitions

Jobtome; Alcony (OH); On-site; USD 66,000 - 130,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare is seeking an experienced leader to supervise a multidisciplinary team delivering care management, utilization management, behavioral health, and LTSS. The role focuses on ensuring quality, cost-effective member care, regulatory compliance, and high performance across the care continuum.

Ideal candidates have 5+ years in healthcare, relevant clinical licensure, and strong cross-functional collaboration skills.

Qualifications

• At least 5 years of health care experience with exposure to managed care
• RN/Licensed practical nurse (LPN), LCSW, LMFT, LPCC, LMSW, or other clinical licensure/certification per state contract needs
• Strong customer service and member-centric orientation
• Ability to work across diverse settings and populations
• Proficiency with Microsoft Office and care-management software

Responsibilities

• Oversees team performance in care management, utilization management, transition of care, behavioral health, LTSS, and/or special programs
• Facilitates proactive healthcare services management while ensuring regulatory compliance
• Acts as a hands-on leader supporting system assessment and day-to-day operations
• Ensures staffing adequacy and customer satisfaction through monitoring productivity
• Implements care management, utilization management, and LTSS activities in line with contract and accreditation standards
• Ensures services align with Molina's customer service standards

Skills

Healthcare operations

RN/LPN/LCSW licensure

Customer service

Cross-functional collaboration

Microsoft Office

Education

RN/Licensed practical nurse (LPN) or equivalent

Tools

Microsoft Office

Job description

Molina Healthcare is seeking an experienced leader to supervise a multidisciplinary team delivering care management, utilization management, behavioral health, and LTSS. The role focuses on ensuring quality, cost-effective member care, regulatory compliance, and high performance across the care continuum.

Ideal candidates have 5+ years in healthcare, relevant clinical licensure, and strong cross-functional collaboration skills.