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ATTENTION JOB SEEKERS AND MOLINA APPLICANTS: FRAUD ALERT

Be aware that third parties posing as Molina Healthcare may be soliciting money from job seekers and extending offers to candidates who have not interviewed. Molina does not engage in these type of practices. If you have received an offer and have not been engaging with Molina Healthcare in an interview process, reach out to erc@molinahealthcare.com to validate the legitimacy of your offer. Please note that Molina has reported this activity to the appropriate law enforcement agencies for further investigation. If you feel you’ve been victimized, please report it to local law enforcement.

COE UM Program Director

Molina Healthcare Arizona; Kentucky; Michigan; Nebraska; Texas; Tucson, Arizona; Chandler, Arizona; Tampa, Florida; Orlando, Florida; Atlanta, Georgia; Nampa, Idaho; Des Moines, Iowa; Louisville, Kentucky; Lincoln, Nebraska; Kearney, Nebraska; Syracuse, New York; Akron, Ohio; Madison, Wisconsin; New Mexico; Augusta, Georgia; Macon, Georgia; Santa Fe, New Mexico; Salt Lake City, Utah; Seattle, Washington; Vancouver, Washington; Iowa Job ID 2029187
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JOB 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

  • Manages one or more Healthcare Services clinical programs using staff and matrixed resources with oversight from AVP and VP as needed.
  • May supervise one or more Program Managers.
  • Serves as industry Subject Matter Expert in the functional area and leads programs to meet critical needs.
  • Escalates gaps and barriers in implementation and compliance to AVP, VP and senior management.
  • Consultative role, develops business case methodologies for programs, develops and coordinates implementation of business strategy.
  • Collaborates and facilitates activities with other units at corporate and Molina Plans.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree in Healthcare-related field (equivalent combination of education, experience and/or Nursing license will be considered in lieu of Bachelor's Degree).

Required Experience

  • 7+ years managed healthcare experience with line management responsibility including clinical operations.
  • Experience working within applicable state, federal, and third-party regulations.

Required License, Certification, Association

If licensed, license must be active, unrestricted and in good standing.

Preferred Education

Bachelor's Degree in Nursing or a master’s degree in Business, Social Work or other healthcare related field.

Preferred Experience

  • 10+ years managed care experience
  • Operational and process improvement experience

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: $88,453 - $206,981 / 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: 12/11/2024

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