Skip to main content
Search Jobs

Let us search jobs for you based on the skills and experience listed in your LinkedIn profile.

Start Matching Jobs
close message

We recommend using Google Chrome, Mozilla Firefox, Microsoft Edge, or Apple Safari to complete an application.

Director, Healthcare Services (Remote in Massachusetts)

Molina Healthcare Boston, Massachusetts Job ID 2006540
Apply Now


RI and NH locations may be considered, as well as candidates interested in relocating

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.

• Directs and oversees one of the following key Healthcare Services functions: case management/disease management/care transitions; utilization management (Position oversees PA authorizations and manages the inpatient certification review staff for initial, concurrent or retrospective reviews); long-term supports and services; or nurse advice line.
• Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care review and management.
• Develops, performs and promotes interdepartmental integration and collaboration to enhance clinical services.
• Collaborates with and keeps the AVP or VP of Healthcare Services informed of operational issues, staffing, resources, system and program needs and presents solution action plan for issues.
• Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote standardized Molina enterprise wide approach to Care Management programs.
• Ensures monthly auditing is occurring with appropriate follow-up.
• Engaged in clinical training activities and outcomes.
• Develops and mentors HCS managers and supervisors.
• This a full-time position.
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
Master's Degree in Business, Healthcare, Social Work or 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.

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: 01/20/2021


View Map

Job Alerts

Sign up to receive automatic notices when jobs that match your interests are posted.

By uploading your resume you are not submitting an application for employment

Interested InSelect a job category from the list of options. Search for a location and select one from the list of suggestions. Finally, click “Add” to create your job alert.

  • Healthcare Services, Boston, Massachusetts, United StatesRemove