Overview
Provides lead level non-clinical healthcare services support for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
- Assists in training of staff according to department standards, policies and procedures.
- Evaluates work performance of healthcare services department staff; consults with leadership to devise and implement corrective action as necessary to improve staff performance.
- Acts as a supportive resource to healthcare services department staff, assisting in devising/implementing strategies of assignment delegation and facilitating department processes and communicating/coordinating activities.
- Resolves problems and complaints that may arise in day-to-day operations that involve healthcare services department staff; communicates findings to leadership for resolution.
- Maintains a minimal caseload (as determined by leadership).
- Ensures communication and adherence to appropriate guidelines and support staff with daily operational and administrative compliance activities.
- Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing issues, system and program needs.
- Monitors healthcare services department staff workload for adherence to the department policies, procedures, guidelines and deadlines; ensures oversight and direction of individuals primarily responsible and timely completion.
- Actively participates in department auditing program to review and communicate findings with staff and identify opportunities for improved quality and compliance.
- Acts as liaison to both internal and external customers on behalf of both Molina and healthcare services department areas.
- Conducts in a professional manner at all times; maintains confidentiality, cooperation, effective workplace relationships and adheres to company code of conduct.
- Attends/participates in departmental, company-wide, and external committees, task forces, or work groups as assigned.
- Shares monthly quality and productivity scores with individual staff for awareness.
Required Qualifications
- At least 4 years of operations or administrative experience in health care, preferably within a managed care setting, or equivalent combination of relevant education and experience in an administrative support or medical assistant role in health care, or equivalent combination of relevant education and experience.
- Excellent customer service skills.
- Strong analytic and problem-solving abilities.
- Strong time-management and organizational skills.
- Strong verbal and written communication skills.
- Microsoft Office suite proficiency (including Excel), and applicable software program(s) proficiency.
Preferred Qualifications
- Certified Medical Assistant (CMA).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
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Pay Range: $20.74 - $40.44 / HOURLY
- Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.