Senior Managed Care Leader, Healthcare Services

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

Job summary

Molina Healthcare is seeking an experienced Managed Care Leader in Southern California to guide a multidisciplinary team across care management, utilization management, and LTSS. The role emphasizes member-centered care, performance improvements, and cross-functional collaboration.

The position requires 7+ years in healthcare with 3+ in managed care, plus 1+ year of leadership. Travel may be required, and the company offers competitive benefits.

Qualifications

• 7+ years of healthcare experience with at least 3 years in managed care/CARE management.
• 1+ year of management/leadership experience.
• Clinical licensure/certification required if state contract/regulatory mandates.
• Strong customer service and member-centric focus.
• Ability to lead teams and collaborate across a matrixed organization.

Responsibilities

• Oversees performance for care management, utilization management, LTSS, or related programs.
• Leads and integrates care management with regulatory and accreditation standards.
• Manages day-to-day operations and staffing to ensure service levels.
• Monitors staff productivity and key performance metrics.
• Collaborates with senior leadership to address operational needs and program improvements.
• Reports on care access, utilization, and outcomes to optimize cost-effectiveness.

Skills

Healthcare leadership

Care management

Cross-functional collaboration

Communication skills

Customer service focus

Education

Clinical licensure/certification (RN/LVN/LPN/LCSW/LMFT/LPCC/LMSW)

Tools

Microsoft Office

Healthcare software

Job description

Molina Healthcare is seeking an experienced Managed Care Leader in Southern California to guide a multidisciplinary team across care management, utilization management, and LTSS. The role emphasizes member-centered care, performance improvements, and cross-functional collaboration.

The position requires 7+ years in healthcare with 3+ in managed care, plus 1+ year of leadership. Travel may be required, and the company offers competitive benefits.