Supervisor, Healthcare Services

Molina Healthcare, Inc.; Orlando (FL); On-site; USD 66,000 - 130,000; Full time

Job summary

Molina Healthcare, Inc. in Florida seeks a healthcare services leader to supervise a multidisciplinary team across care management, utilization management, behavioral health, and LTSS. You will drive integrated delivery, ensure regulatory compliance, and improve member outcomes and cost efficiency.

You will lead, develop and monitor staff performance, coordinate with senior leaders, and promote collaboration to sustain high-quality, access-focused care for Molina members.

Qualifications

• At least 5 years of health care experience with 2 years in managed care or equivalent.
• RN/LVN/LPN or licensed social work/therapy licensure; active and unrestricted as required.
• Strong customer service focus and member-centric approach.
• Ability to work across diverse populations and settings.
• Ability to manage multiple deadlines with solid organizational skills.
• Excellent written and verbal communication; cross-functional collaboration.
• Proficient with Microsoft Office and basic software tools.

Responsibilities

• Oversees team performance in care management, utilization management, LTSS, or related functions.
• Facilitates integrated, proactive healthcare services management with compliance to standards.
• Provides hands-on leadership, assesses systems, and enhances day-to-day operations.
• Ensures staffing and service levels; tracks productivity and performance indicators.
• Implements program activities per regulatory, contract, and accreditation requirements.
• Ensures care delivery aligns with Molina's customer service standards.
• Supports high-risk, complex members; monitors care and outcomes.
• Collaborates with senior leadership on operational issues and resource needs.
• Promotes interdepartmental integration to improve continuity of care.
• Leads ICT meetings and analyzes care access and utilization data.
• Conducts staff quality audits and drives enhancements for cost-effectiveness.
• Maintains professional relationships with providers, customers, and state agencies.
• Identifies opportunities for care delivery and process improvements.
• Hires, trains, and develops team; manages performance against goals.
• Local travel may be required as per state/contractual needs.

Skills

Customer service

Leadership

Communication skills

Team collaboration

Office software

Education

Registered Nurse (RN) licensure

Licensed Vocational Nurse (LVN) licensure

Licensed Practical Nurse (LPN) licensure

Licensed Clinical Social Worker (LCSW)

Licensed Marriage and Family Therapist (LMFT)

Licensed Professional Clinical Counselor (LPCC)

Licensed Master of Social Work (LMSW)

Tools

MS Office

Job description

JOB DESCRIPTION Job Summary

Leads and supervises a multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or special programs. Ensures members reach desired outcomes through integrated delivery and coordination of care across the continuum, and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• Oversees team performance for one or more of the following healthcare services functions: care management, utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), transition of care, behavioral health, long-term services and supports (LTSS), and/or special programs.
• Facilitates integrated, proactive healthcare services management - ensuring compliance with state and federal regulatory and accrediting standards and implementation of the Molina clinical model.
• Functions as a "hands-on" leader - assisting with assessing and evaluation of systems, day-to-day operations and efficiency of services/care delivery.
• Ensures adequate staffing and service levels and maintains customer satisfaction by implementing and monitoring staff productivity and other performance indicators.
• Assists in implementing care management, utilization management, behavioral health, care transitions, LTSS and other program activities in accordance with regulatory, contract standards and accreditation compliance.
• Ensures delivery of member care and services are aligned with Molina's established standards of customer service excellence.
• Ensures high-risk, complex members are adequately supported.
• Oversees ongoing monitoring of performance, protocols and guidelines related to healthcare services.
• Collaborates with and keeps senior level healthcare services leadership apprised of operational issues, staffing, resources, system and program needs.
• Performs and promotes interdepartmental/multidisciplinary integration and collaboration to enhance continuity of care.
• Oversees interdisciplinary care team (ICT) meetings.
• Analyzes and reports on care access and monitoring statistics including plan utilization, staff productivity, cost-effective utilization of services, management of targeted member population, and triage activities.
• Ensures completion of staff quality audit reviews evaluates services provided, outcomes achieved and recommends enhancements/improvements for programs and staff development to ensure consistent cost-effectiveness and compliance with all state and federal regulations and guidelines.
• Maintains professional relationships with provider community, internal and external customers, and state agencies as appropriate.
• Identifies opportunities for care delivery/quality/operational/etc. process improvements.
• Hires, trains, develops and manages team demonstrates accountability for team performance and achievement of department-specific goals.
• Local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 5 years of health care experience, including at least 2 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or special programs, or equivalent combination of relevant education and experience, or equivalent combination of relevant education and experience.
• Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
• Strong customer service skills/member-centric focus.
• Ability to work within a variety of settings and adjust style as needed, including ability to work with diverse populations, various personalities and personal situations.
• Ability to prioritize and manage multiple deadlines.
• Strong organizational and problem-solving skills.
• Ability to collaborate cross-functionally within a highly matrixed organization.
• Strong written and verbal communication skills.
• Microsoft Office suite and applicable software program(s) proficiency.

Preferred Qualifications

• Management/leadership experience.
• Clinical experience.
• Registered Nurse (RN) or master's level behavioral health (BH) licensure. License must be active and unrestricted in state of practice.
• Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification.
• Medicaid/Medicare population experience.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $66,456 - $129,590 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.