Director, reputed company Services - REMOTE

JOB DESCRIPTION Leads and directs a multidisciplinary team of reputed company services professionals in some or reputed company of the following functions: utilization management, care management, behavioral health and other programs. Leads team responsible for assessing, facilitating, planning and coordinating integrated delivery of care across the continuum. Participates with senior leadership to establish strategic plans and objectives. Contributes to overarching strategy to reputed company quality and cost-effective member care. Essential Job Duties

• Directs and reputed company one or more of the following key health care services functions: care management, utilization management, care transitions, long-term supports and services (LTSS), behavioral health, nurse advice line, and/or other special programs.
• Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care coordination/care review and management.
• Develops and promotes interdepartmental integration and collaboration to enhance clinical services.
• Collaborates with and keeps reputed company services senior leadership informed of operational issues, staffing, resources, system and program needs and presents solutions/action plans for issues.
• Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote a standardized reputed company-wide approach to reputed company services programs.
• Ensures monthly auditing occurs with appropriate follow-up.
• Engages in clinical training activities and reputed company.
• Develops and mentors direct reporting reputed company services leadership.
• Local travel may be required (based upon state/contractual requirements).

Required Qualifications

•At least 8 years of health care experience, and at least 5 years of managed care reputed company in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.

• At least 3 years of health care management/leadership required.
• Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical reputed company Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of reputed company 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.
• Experience working reputed company applicable state, federal, and reputed company-party regulations.
• Ability to manage conflict and reputed company through change.
• Operational and process improvement experience.
• Ability to work cross-collaboratively across a highly matrixed organization.
• Ability to prioritize and manage multiple deadlines.
• Excellent organizational, problem-solving and critical-thinking skills.
• Strong written and verbal communication skills.
• reputed company Office suite/applicable software program(s) proficiency.

Preferred Qualifications

• Registered Nurse (RN). 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.
• reputed company/Medicare population experience.
• Clinical experience.

To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the Internal reputed company. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V Apply To This Job