Manager, Healthcare Services

Job description

JOB DESCRIPTION: Job Summary: Leads and manages multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs. Ensures members reach desired outcomes through integrated delivery and coordination of care across the continuum, and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties: - Responsible for leading and managing performance of one or more of the following activities: care review, care management, utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), transition of care, health management, behavioral health, long-term services and supports (LTSS), and/or member assessment. - Facilitates integrated, proactive healthcare services management - ensuring compliance with state and federal regulatory and accrediting standards and implementation of the Molina clinical model. - Manages and evaluates team member performance, provides coaching, employee development and recognition, ensures ongoing appropriate...