Job Title

JOB DESCRIPTION Job SummaryProvides subject matter expertise and leadership to healthcare services function - providing support for project/program/process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, policies and contractual commitments. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Dutiesu2022 Collaboratively plans and executes internal healthcare services projects and programs involving department or cross-functional teams of subject matter experts - delivering products from the design process to completion. u2022 Provides ongoing communication related to program goals, evaluation and support to ensure compliance with standardized protocols and processes. u2022 May engage and oversee the work of external vendors. u2022 Focuses on process improvement, organizational change management, program management and other processes relative to business needs. u2022 Serves as a subject matter expert and leads healthcare services programs to meet critical needs. u2022 Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements. u2022 Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality initiatives within the department as appropriate. u2022 Creates business requirements documents (BRDs), test plans, requirements traceability matrix (RTMs), user training materials and other related business documents. Required Qualifications u2022 At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience. u2022 Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. u2022 Strong analytical and problem-solving skills. u2022 Strong organizational and time-management skills. u2022 Ability to work in a cross-functional, professional environment. u2022 Experience working within applicable state, federal, and third-party regulations. u2022 Strong verbal and written communication skills. u2022 Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications u2022 Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification. u2022 Leadership experience. u2022 Medicaid/Medicare population experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $77,969 - $142,549 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.