Manager, Healthcare Services (RN) Registered Nurse ( California )

Molina Healthcare; Los Angeles (CA); On-site; USD 84,000 - 164,000; Full time

Job summary

A healthcare management organization in California seeks a dedicated leader to oversee a team of healthcare professionals. The role requires at least 7 years of experience in healthcare settings, including management experience. Responsibilities include ensuring quality patient care, compliance with regulations, and staff development. The position offers a competitive salary package with benefits.

Benefits

Competitive benefits and compensation package

Qualifications

• At least 7 years in healthcare, including 3 years in managed care.
• At least 1 year of healthcare management leadership experience.
• Must have an active RN license in practice state.

Responsibilities

• Lead and manage multidisciplinary healthcare teams.
• Ensure compliance with regulatory standards and the Molina clinical model.
• Manage and evaluate team performance and staff development.

Skills

Leadership

Problem-solving

Communication

Time-management

Detail-oriented

Education

Registered Nurse (RN)

Tools

Microsoft Office

Job description

Overview

California resident preferred.

JOB DESCRIPTION

Job Summary

Leads and manages multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs. Ensures members reach desired outcomes through integrated delivery and coordination of care across the continuum, and contributes to overarching strategy to provide quality and cost-effective member care.

Responsibilities

• Responsible for leading and managing performance of one or more of the following activities: care review, care management, transition of care, health management, behavioral health, long-term services and supports (LTSS), and/or member assessment.
• Facilitates integrated, proactive healthcare services management - ensuring compliance with state and federal regulatory and accrediting standards and implementation of the Molina clinical model.
• Manages and evaluates team member performance, provides coaching, employee development and recognition, ensures ongoing appropriate staff training, and has responsibility for selection, orientation and mentoring of new staff.
• Performs and promotes interdepartmental/multidisciplinary integration and collaboration to enhance continuity of care.
• Oversees interdisciplinary care team (ICT) meetings.
• Functions as hands-on manager responsible for supervision and coordination of daily integrated healthcare service activities.
• Ensures adequate staffing and service levels and maintains customer satisfaction by implementing and monitoring staff productivity and other performance indicators.
• Collates and reports on care access and monitoring statistics including plan utilization, staff productivity, cost-effective utilization of services, management of targeted member population, and triage activities.
• Ensures completion of staff quality audit reviews; evaluates services provided, outcomes achieved and recommends enhancements/improvements for programs and staff development to ensure consistent cost-effectiveness and compliance with all state and federal regulations and guidelines.
• Maintains professional relationships with provider community, internal and external customers, and state agencies as appropriate, while identifying opportunities for improvement.
• Local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 7 years experience in health care, and at least 3 years of managed care experienced in one or more of the following areas: care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
• At least 1 year of health care management leadership experience.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Experience working within applicable state, federal, and third party regulations.
• Demonstrated knowledge of community resources.
• Proactive and detail-oriented.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to work independently, with minimal supervision and demonstrate self-motivation.
• Responsive in all forms of communication, and ability to remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving and critical-thinking skills.
• Excellent verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

• Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification.
• Medicaid/Medicare population experience.
• Clinical experience.

Work Schedule

California Pacific Time Zone, daytime business hours. Candidates who do not live in CA must work Pacific hours permanently.

Equal Opportunity

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

Pay Range: $84,067 - $163,931 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.