Remote RN Director: Inpatient Utilization & Care Management

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

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare in California seeks an experienced healthcare Services Administrator to lead utilization management, care management and related programs. The role requires California RN licensure and significant IPA delegation experience.

You will direct a multidisciplinary team, develop standardized protocols, collaborate with senior leadership, and ensure compliant, cost-effective member care with cross-functional partners. Local travel may be required.

Qualifications

• 8+ years health care experience with 5+ years in managed care.
• 3+ years health care management/leadership experience.
• Current active licensure as RN/LVN/LPN or equivalent unless not required by contract.

Responsibilities

• Directs and oversees care management, utilization management, LTSS and behavioral health functions.
• Develops protocols to facilitate integrated proactive care coordination.
• Promotes interdepartmental collaboration and reports operational needs to senior leadership.
• Leads committees and cross-functional teams to standardize enterprise-wide healthcare services.
• Ensures monthly audits with follow-up and supports clinical training and mentorship.
• Local travel may be required based on state/contract requirements.

Skills

Healthcare leadership

Care management

Regulatory compliance

Communication

MS Office

Education

RN/LVN/LPN/LCSW/LMFT/LPCC/LMSW licensure

Tools

Microsoft Office

Job description

Molina Healthcare in California seeks an experienced healthcare Services Administrator to lead utilization management, care management and related programs. The role requires California RN licensure and significant IPA delegation experience.

You will direct a multidisciplinary team, develop standardized protocols, collaborate with senior leadership, and ensure compliant, cost-effective member care with cross-functional partners. Local travel may be required.