Remote WA Utilization & Care Management Director

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

Job summary

Molina Healthcare seeks an experienced healthcare services leader for a remote role that must be local to Washington state and support PST hours. You will oversee utilization management, care coordination, and behavioral health initiatives, guiding cross-functional teams to deliver high‑quality care.

The role requires at least 8 years in health care with 3+ years in management, plus active licensure in a relevant clinical field. Strong collaboration and regulatory compliance are essential.

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.
• RN/LVN/LPN/LCSW/LMFT/LPCC/LMSW with active license if required by state rules.
• Strong customer service skills and member-centric focus.
• Ability to work across settings with diverse populations.
• Ability to prioritize and manage multiple deadlines.
• Strong organizational and problem-solving skills.
• Ability to collaborate cross-functionally within a matrixed org.
• Excellent written and verbal communication skills.
• Microsoft Office suite proficiency.

Responsibilities

• Oversees team performance for utilization management, behavioral health, and/or special programs.
• Facilitates integrated, proactive healthcare services management in line with standards.
• Develops, implements and monitors standardized protocols for care coordination.
• Promotes interdepartmental integration to enhance clinical services.
• Acts as hands-on leader assisting with day-to-day operations and efficiency.
• Ensures staffing levels and customer satisfaction by monitoring productivity.
• Implements program activities in accordance with regulatory and contract standards.
• Delivers member care aligned with Molina's customer service standards.
• Oversees ongoing monitoring of performance and guidelines.
• Collaborates with senior leadership and presents remediation plans.
• Leads interdisciplinary care team meetings and analytics.
• Maintains relationships with provider community and state agencies.
• Identifies opportunities for process improvements.

Skills

Healthcare leadership

Regulatory compliance

Care coordination

Staff development

Data analysis

Cross-functional collaboration

Customer service

MS Office

Education

RN/LVN/LPN or equivalent license

Tools

Microsoft Office

Job description

Molina Healthcare seeks an experienced healthcare services leader for a remote role that must be local to Washington state and support PST hours. You will oversee utilization management, care coordination, and behavioral health initiatives, guiding cross-functional teams to deliver high‑quality care.

The role requires at least 8 years in health care with 3+ years in management, plus active licensure in a relevant clinical field. Strong collaboration and regulatory compliance are essential.