Remote Director, Healthcare Utilization & Care Coordination

Jobtome; Tacoma (WA); Remote; USD 88,000 - 198,000; Full time

Job summary

Molina Healthcare is seeking a senior healthcare services leader to oversee utilization management, care coordination, and behavioral health programs. The role supports PST hours and requires a WA-based candidate for remote work.

You will guide interdisciplinary teams, ensure regulatory compliance, monitor performance metrics, and drive process improvements while maintaining strong relationships with providers and stakeholders.

Qualifications

• At least 8 years of health care experience, including at least 5 years in managed care.
• At least 3 years of management/leadership experience.
• Licensure in a clinical field only if required by state contract/regulation; active in state of practice.
• Strong customer service skills and member-centric focus.
• Excellent written and verbal communication; ability to collaborate cross-functionally.

Responsibilities

• Oversees team performance for utilization management, behavioral health, and/or special programs.
• Ensures compliance with state/federal standards and Molina clinical model.
• Develops and monitors standardized protocols to coordinate care.
• Promotes interdepartmental integration to enhance clinical services.
• May act as hands-on leader assessing systems and day-to-day operations.
• Maintains staffing levels and monitors productivity and performance metrics.
• Implements and monitors utilization management and program activities per regulations.
• Delivers care aligned with customer service excellence.
• Collaborates with senior leadership and presents remediation plans.
• Oversees ICT meetings and analyzes care access and outcomes.

Skills

Healthcare leadership

Customer service

Communication skills

Time management

Cross-functional collaboration

Education

Nursing or Social Work licensure (RN/LVN/LPN/LCSW/LMFT/LPCC/LMSW, active)

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a senior healthcare services leader to oversee utilization management, care coordination, and behavioral health programs. The role supports PST hours and requires a WA-based candidate for remote work.

You will guide interdisciplinary teams, ensure regulatory compliance, monitor performance metrics, and drive process improvements while maintaining strong relationships with providers and stakeholders.