Inpatient Utilization Mgmt Director (Remote CA)

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

Job summary

Molina Healthcare in California is seeking a senior leader to oversee multidisciplinary healthcare services teams, including utilization and care management, behavioral health, and related programs. The role requires California RN licensure and significant IPA delegation experience.

The position directs teams, develops protocols, promotes interdepartmental integration, and reports to senior leadership. Local travel may be required to meet state contract requirements.

Qualifications

• 8+ years health care experience with 5+ years in managed care.
• 3+ years health care management/leadership.
• RN, LVN, LPN, LCSW, LMFT, LPCC, or LMSW license; active and unrestricted as required by state.
• Experience with state, federal, and third-party regulations.
• Ability to manage conflict and lead through change.
• Operational/process improvement experience.
• Cross-functional collaboration in a matrixed organization.
• Proficiency in Microsoft Office.

Responsibilities

• Directs and oversees care management, utilization management, care transitions, LTSS, behavioral health, nurse advice line, and related programs.
• Develops and monitors standardized protocols for clinical and non-clinical team activities.
• Promotes interdepartmental integration to enhance clinical services.
• Keeps senior leadership informed of operational issues and presents solutions.
• Leads committees and multidisciplinary teams to promote enterprise-wide standardization.
• Ensures monthly auditing with appropriate follow-up.
• Engages in clinical training activities and outcomes.
• Develops and mentors direct reporting healthcare services leadership.
• Local travel may be required based on state/contractual requirements.

Skills

Health care experience

Managed care experience

Leadership

Communication skills

Regulatory knowledge

Microsoft Office

Education

RN licensure (CA)

Tools

Microsoft Office

Job description

Molina Healthcare in California is seeking a senior leader to oversee multidisciplinary healthcare services teams, including utilization and care management, behavioral health, and related programs. The role requires California RN licensure and significant IPA delegation experience.

The position directs teams, develops protocols, promotes interdepartmental integration, and reports to senior leadership. Local travel may be required to meet state contract requirements.