Healthcare Services Manager: Care & Utilization Leadership

Molina Talent Acquisition; United States; On-site; USD 120,000 - 170,000; Full time

Job summary

Molina Healthcare is seeking a senior healthcare services leader to manage a multidisciplinary team focused on care management, utilization management, behavioral health, LTSS, and related programs in the United States. You will drive integrated care delivery, ensure regulatory compliance, and lead strategic improvements to meet quality and cost objectives.

In this role, you will oversee staffing, performance, and program activities, collaborate with senior leadership, and champion

Qualifications

• 7+ years in health care with managed care experience in care management, utilization management, LTSS, or related areas
• 1+ year of management/leadership experience
• Active licensure where required by state contract/regulation/operating model
• Strong customer service orientation and patient/member focus
• Ability to collaborate in a highly matrixed organization
• Proficiency with Microsoft Office and healthcare software

Responsibilities

• Oversees team performance for care management, utilization management, LTSS, and/or special programs.
• Facilitates integrated, proactive healthcare services management with regulatory and accreditation compliance.
• Acts as a hands-on leader, assessing and improving day-to-day operations and care delivery.
• Ensures staffing and service levels meet demand and monitors productivity and performance metrics.
• Implements care management activities in line with regulatory and contract standards.
• Ensures services align with Molina's customer service standards and drives high-quality care.
• Monitors high-risk, complex members and maintains effective program support.
• Collaborates with senior leadership to address operational issues, resources, and system needs.
• Promotes interdepartmental integration to enhance continuity of care and leads ICT meetings.
• Analyzes care access and utilization statistics to guide improvements and reporting.
• Conducts staff quality audits and recommends enhancements for efficiency and compliance.
• Maintains relationships with providers, customers, and state agencies; identifies care delivery improvements.
• Leads recruitment, training, and development of the team with accountability for goals.
• Travel may be required based on state/contract requirements.

Skills

People management

Communication skills

Strategic planning

Problem solving

Microsoft Office

Education

RN or LCSW/LMFT/LPCC/LMSW licensure (state-specific)

Tools

Microsoft Office Suite

Job description

Molina Healthcare is seeking a senior healthcare services leader to manage a multidisciplinary team focused on care management, utilization management, behavioral health, LTSS, and related programs in the United States. You will drive integrated care delivery, ensure regulatory compliance, and lead strategic improvements to meet quality and cost objectives.

In this role, you will oversee staffing, performance, and program activities, collaborate with senior leadership, and champion