Remote RN Lead, Inpatient Utilization & Care Management

Molina Healthcare; Bakersfield (CA); Hybrid; USD 102,000 - 198,000; Full time

Job summary

Molina Healthcare in California seeks a senior leader to direct a multidisciplinary team across utilization management, care management, and behavioral health. You will lead programs to coordinate care delivery and collaborate with senior leadership to drive strategic plans for quality and cost-effective member care.

Applicants must hold a California RN license with extensive managed care experience and reside in California.

Qualifications

• Requires California RN licensure and significant IPA delegation experience.
• Strong leadership and management experience in health care settings.
• Proven ability to lead cross-functional teams and drive programs across care delivery.

Responsibilities

• Directs and oversees care management, utilization management, care transitions, LTSS, behavioral health, and related programs.
• Develops and implements standardized care protocols to enable proactive care coordination.
• Promotes interdepartmental collaboration and reports operating needs and solutions to senior leadership.
• Facilitates committees and multidisciplinary teams to standardize enterprise-wide health services programs.
• Ensures monthly auditing with follow-up and monitors outcomes.
• Engages in clinical training and mentors health services leadership.
• Local travel may be required based on state/contractual requirements.

Education

RN License

LCSW / LMFT / LPCC / LMSW Licenses

Job description

Molina Healthcare in California seeks a senior leader to direct a multidisciplinary team across utilization management, care management, and behavioral health. You will lead programs to coordinate care delivery and collaborate with senior leadership to drive strategic plans for quality and cost-effective member care.

Applicants must hold a California RN license with extensive managed care experience and reside in California.