VP, Healthcare Services in Georgia
Molina Healthcare Albany, New York; Everett, Washington; New York; Idaho; Wisconsin; Kentucky; Iowa; Texas; Utah; Nebraska; Florida; Washington; Ohio; Arizona; Michigan; New Mexico; Rochester, New York; Dayton, Ohio; Santa Fe, New Mexico; Tacoma, Washington; Caldwell, Idaho; Sioux City, Iowa; Madison, Wisconsin; Louisville, Kentucky; Orlando, Florida; Des Moines, Iowa; Cedar Rapids, Iowa; Vancouver, Washington; Meridian, Idaho; New York, New York; Mesa, Arizona; Dallas, Texas; Green Bay, Wisconsin; Omaha, Nebraska; Buffalo, New York; Racine, Wisconsin; Phoenix, Arizona; Provo, Utah; Sterling Heights, Michigan; Spokane, Washington; Kenosha, Wisconsin; Milwaukee, Wisconsin; Nampa, Idaho; Miami, Florida; Seattle, Washington; St. Petersburg, Florida; Layton, Utah; Kearney, Nebraska; Yonkers, New York; Boise, Idaho; Warren, Michigan; Syracuse, New York; Las Cruces, New Mexico; Lexington-Fayette, Kentucky; Covington, Kentucky; Jacksonville, Florida; Chandler, Arizona; Lincoln, Nebraska; San Antonio, Texas; Bowling Green, Kentucky; Fort Worth, Texas; Akron, Ohio; Grand Rapids, Michigan; Austin, Texas; Houston, Texas; Grand Island, Nebraska; Tucson, Arizona; Bellevue, Nebraska; Idaho Falls, Idaho; Albuquerque, New Mexico; Tampa, Florida; Detroit, Michigan; Owensboro, Kentucky; Davenport, Iowa; Roswell, New Mexico; Bellevue, Washington; Cincinnati, Ohio; Cleveland, Ohio; Iowa City, Iowa; West Valley City, Utah; Orem, Utah; Ann Arbor, Michigan; Salt Lake City, Utah; Rio Rancho, New Mexico; Scottsdale, Arizona; Atlanta, Georgia; Macon, Georgia; Savannah, Georgia; Augusta, Georgia; Columbus, Georgia Job ID 2031087JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
KNOWLEDGE/SKILLS/ABILITIES
The VP, Healthcare Services is responsible for oversight and management of the state health plan's Healthcare Services (clinical operations) teams including Utilization Management (prior-authorization, inpatient review) and Care Management (case/health management and transition of care). This position works collaboratively with the Chief Medical Officer to develop and implement processes to effectively manage clinical policies to meet healthcare cost and quality targets.
- Works with the Healthcare Services management team to achieve successful implementation of Molina clinical strategy and direction.
- Develops and implements effective and efficient standards, protocols, processes, decision support systems, reporting and benchmarks that support ongoing improvements of clinical operations functions and promote quality cost effective health care for Molina members.
- Mentors, guides, and develops skills of management team members in a consistent and effective manner.
- Develops initiatives to achieve budgeted reductions in medical expenses and increases in quality scores.
- Develops Healthcare Services department budget and ensures budget targets are met.
- Manages implementation of analytical studies that quantify the benefits of Healthcare Services programs to ensure that resources are appropriately allocated, operational controls exist, and efficiencies are maximized.
- Facilitates integration of care coordination, long term care, behavioral health, and chemical dependency programs.
- Continually refines operational processes and champions review of team processes, workflows, and activities.
- Articulates project requirements and anticipated outcomes to the Molina Project Management Office for identified projects/strategies to improve the efficiency of clinical operations teams to meet cost and quality goals.
- Accountable for ensuring compliance with contractual, accreditation and regulatory requirements for all Healthcare Services teams.
- Participates personally or assigns appropriate staff to Molina Quality Committees and external Community Committees to represent the Healthcare Services department.
- Ensures effective inter-departmental collaboration and interaction between Healthcare Services staff and other departments.Â
- Ensures monthly auditing of HCS staff is performed and appropriate actions and/or coaching occur.
- Responsible for oversight of clinical training activities and outcomes.
- Responsible for HCS-related delegation oversight monitoring.
JOB QUALIFICATIONS
Required Education
Master's Degree or equivalent combination of education and work experience.
Required Experience
- 10 years managed care experience with line management responsibility including clinical operations.Â
- Experience working within applicable state, federal, and third-party regulations.Â
- Operational and process improvement experience.
- Strong communication and teaming/interpersonal skills.
- Strong leadership capabilities and ability to initiate and maintain cross-team relationships.
- Demonstrated experience meeting Quality Accreditation Standards (NCQA/HEDIS/STARS).
Required License, Certification, Association
If licensed, license must be active, unrestricted and in good standing.
Preferred Education
Master’s Degree in Business or Healthcare management (i.e. MBA, MHA, MPH).
Preferred Experience
Familiarity and experience in the local market desirable.
Preferred License, Certification, Association
- Active, unrestricted State Registered Nursing (RN) license in good standing.
- Utilization Management Certification (CPHM) Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $140,795 - $274,550.26 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 04/01/2025ABOUT OUR LOCATION
View Map- Lead Engineer, Applications Omaha Nebraska, Las Cruces New Mexico, Buffalo New York, Wisconsin, Kentucky, Warren Michigan, Houston Texas, Miami Florida, Yonkers New York, Caldwell Idaho, St. Petersburg Florida, Ann Arbor Michigan, Orlando Florida, Louisville Kentucky, Spokane Washington, Owensboro Kentucky, West Valley City Utah, Dayton Ohio, Jacksonville Florida, Salt Lake City Utah, Nampa Idaho, Covington Kentucky, Utah, Grand Island Nebraska, Macon Georgia, Mesa Arizona, Roswell New Mexico, Cedar Rapids Iowa, Augusta Georgia, Austin Texas, Racine Wisconsin, San Antonio Texas, Michigan, New York, Nebraska, Kenosha Wisconsin, Vancouver Washington, Rio Rancho New Mexico, Columbus Ohio, Detroit Michigan, Green Bay Wisconsin, Syracuse New York, Lincoln Nebraska, Sioux City Iowa, Georgia, Idaho, New Mexico, Florida, Chandler Arizona, Scottsdale Arizona, Columbus Georgia, Rochester New York, Akron Ohio, Orem Utah, Albuquerque New Mexico, Lexington-Fayette Kentucky, Tacoma Washington, Texas, Milwaukee Wisconsin, Meridian Idaho, Fort Worth Texas, Bellevue Washington, Savannah Georgia, Davenport Iowa, Iowa City Iowa, Layton Utah, Santa Fe New Mexico, Madison Wisconsin, Washington, Ohio, Dallas Texas, Cincinnati Ohio, Des Moines Iowa, Tucson Arizona, Everett Washington, Bellevue Nebraska, Bowling Green Kentucky, Phoenix Arizona, Cleveland Ohio, Grand Rapids Michigan, Iowa, Idaho Falls Idaho, Provo Utah, Tampa Florida, Kearney Nebraska, Atlanta Georgia, Albany New York, Boise Idaho, Sterling Heights Michigan 05/08/2025
- Broker Coord (Remote) Albany New York, Everett Washington, Idaho Falls Idaho, Tampa Florida, Spokane Washington, Ann Arbor Michigan, Savannah Georgia, Grand Rapids Michigan, West Valley City Utah, Phoenix Arizona, New Mexico, Augusta Georgia, Miami Florida, Mesa Arizona, Columbus Georgia, Davenport Iowa, Boise Idaho, Salt Lake City Utah, Washington, Nebraska, Orlando Florida, Fort Worth Texas, Racine Wisconsin, Bellevue Nebraska, Michigan, Bowling Green Kentucky, Santa Fe New Mexico, Georgia, Wisconsin, Utah, Detroit Michigan, Akron Ohio, Austin Texas, Owensboro Kentucky, Sterling Heights Michigan, San Antonio Texas, Iowa, Grand Island Nebraska, Provo Utah, St. Petersburg Florida, Omaha Nebraska, Nampa Idaho, Lexington-Fayette Kentucky, Dallas Texas, Jacksonville Florida, Syracuse New York, Kentucky, Cedar Rapids Iowa, Rochester New York, Yonkers New York, Vancouver Washington, Louisville Kentucky, Des Moines Iowa, Bellevue Washington, Caldwell Idaho, Lincoln Nebraska, Sioux City Iowa, Buffalo New York, Warren Michigan, Layton Utah, Orem Utah, Florida, Madison Wisconsin, Roswell New Mexico, Atlanta Georgia, Milwaukee Wisconsin, New York New York, Scottsdale Arizona, Kenosha Wisconsin, Cincinnati Ohio, Covington Kentucky, Tacoma Washington, Dayton Ohio, Meridian Idaho, Chandler Arizona, Texas, New York, Idaho, Kearney Nebraska, Macon Georgia, Houston Texas, Rio Rancho New Mexico, Columbus Ohio, Tucson Arizona, Green Bay Wisconsin, Iowa City Iowa, Las Cruces New Mexico, Seattle Washington, Cleveland Ohio, Albuquerque New Mexico, Ohio 05/09/2025
- Field Family Nurse Practitioner (Flint, MI) Flint Michigan, Michigan, Iowa, Ohio, Kentucky, Nebraska, Georgia, Arizona, Wisconsin, Washington, Utah, New Mexico, Florida, New York, Idaho, Texas 05/09/2025
- Sr Engineer, Cyber Insider Threat - Network Activity Logs - Remote Albany New York, Everett Washington, Orlando Florida, Columbus Georgia, Davenport Iowa, Lexington-Fayette Kentucky, Louisville Kentucky, Lincoln Nebraska, Bellevue Nebraska, Las Cruces New Mexico, Santa Fe New Mexico, San Antonio Texas, Austin Texas, Salt Lake City Utah, Provo Utah, Kenosha Wisconsin, Chandler Arizona, Tampa Florida, Georgia, Macon Georgia, Iowa, Albuquerque New Mexico, Ohio, Cleveland Ohio, Utah, Madison Wisconsin, Jacksonville Florida, Idaho Falls Idaho, Boise Idaho, Warren Michigan, Yonkers New York, Akron Ohio, Columbus Ohio, Layton Utah, Vancouver Washington, Phoenix Arizona, St. Petersburg Florida, Florida, Meridian Idaho, Covington Kentucky, Kearney Nebraska, Omaha Nebraska, New York New York, Dayton Ohio, Houston Texas, Augusta Georgia, Dallas Texas, Texas, Miami Florida, Cedar Rapids Iowa, Idaho, Bowling Green Kentucky, Sterling Heights Michigan, Nebraska, Grand Island Nebraska, New Mexico, West Valley City Utah, Bellevue Washington, Spokane Washington, Washington, Milwaukee Wisconsin, Scottsdale Arizona, Savannah Georgia, Atlanta Georgia, Iowa City Iowa, Caldwell Idaho, Nampa Idaho, Michigan, New York, Rochester New York, Fort Worth Texas, Wisconsin, Green Bay Wisconsin, Mesa Arizona, Owensboro Kentucky, Kentucky, Grand Rapids Michigan, Detroit Michigan, Roswell New Mexico, Syracuse New York, Cincinnati Ohio, Tacoma Washington, Racine Wisconsin, Tucson Arizona, Des Moines Iowa, Sioux City Iowa, Ann Arbor Michigan, Rio Rancho New Mexico, Buffalo New York, Orem Utah, Seattle Washington 03/26/2025
No recently viewed jobs.
View All JobsNo saved jobs.
View All Jobs