$84k–$164k/yr
Manager, Healthcare Services - Remote (Must Reside in California)
Molina Healthcare · Tulsa, OK
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 staff training, and has responsibility for selection, orientation and mentoring of new staff. • Performs and promotes interdepartmental/multidisciplinary integration and collaboration to enhance continuity of care. • Oversees interdisciplinary care team (ICT) meetings. • Functions as hands-on manager responsible for supervision and coordination of daily integrated healthcare service activities. • Ensures adequate staffing and service levels and maintains customer satisfaction by implementing and monitoring staff productivity and other performance indicators. • Collates and reports on care access and monitoring statistics including plan utilization, staff productivity, cost-effective utilization of services, management of targeted member population, and triage activities. • Ensures completion of staff quality audit reviews; evaluates services provided, outcomes achieved and recommends enhancements/improvements for programs and staff development to ensure consistent cost-effectiveness and compliance with all state and federal regulations and guidelines. • Maintains professional relationships with provider community, internal and external customers, and state agencies as appropriate, while identifying opportunities for improvement. • Local travel may be required (based upon state/contractual requirements). Required Qualifications •At least 7 years experience in health care, and at least 3 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience. • At least 1 year of health care management/leadership experience. • Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. • Experience working within applicable state, federal, and third party regulations. • Demonstrated knowledge of community resources. • Proactive and detail-oriented. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to work independently, with minimal supervision and demonstrate self-motivation. • Responsive in all forms of communication, and ability to remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving and critical-thinking skills. • Excellent verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications Medicaid/Medicare Population experience with increasing responsibility. 3+ years of clinical nursing experience. CalAIM experience, specifically Community Supports Experience working with Community Based Organizations (CBO) or working for a CBO/provider Data/reporting experience, Microsoft Office proficiency (navigate Excel files, reports/dashboards, work directly with reporting teams to provide business requirements) SDOH experience Certified Case Manager (CCM), Certified Professional in Healthcare 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 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: $84,067 - $163,931 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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" Licensed Psychiatric Nurse Practitioner Wage: Up to $199/hour Did you know that you can build a flexible private practice on your terms as a psychiatric nurse practitioner? Whether you want to see patients alongside a full-time job or grow a full-time practice, Headway makes it easy to accept insurance, boost your earnings, and focus on care - without the administrative burden. It's all on one free-to-use platform, no commitment required. About the role This position is for licensed psychiatric nurse practitioners looking to start or grow their private practice. Headway provides the tools, resources, and support to help you navigate insurance, streamline operations, and let you focus on what matters most - your patients. About you • You're a fully licensed psychiatric nurse practitioner with your DEA or CDS number, ANCC or AANP board certification, a valid NPI number and malpractice insurance. • You're looking to start or expand your private practice while maintaining control over your schedule, client load, and work environment. Why partner with Headway? As an independent provider with Headway, you'll gain access to: • Hassle-free insurance credentialing: Get credentialed for free in multiple states within as little as 30 days. • Increased earnings: Secure competitive rates with top insurance plans through our nationwide network. • Predictable bi-weekly payments: Receive reliable payouts directly from Headway. • Built-in EHR tools: Access real-time scheduling, secure client messaging, documentation templates, assessments, and more. • Compliance & audit support: Stay up-to-date with insurance requirements and industry regulations. • Free continuing education: Earn CEUs and expand your expertise through Headway Academy. How Headway supports your patients • Increased access: Headway makes it easier for your clients to get the care they need at a price they can afford through insurance. • Instant verification: Clients can easily check their insurance status and get the care they need without disruption. Important Notes • This is a 1099 independent contractor role. You'll have full autonomy over your practice, including setting your hours and managing your caseload. • At this time, Headway can't support mental health professionals that aren't fully licensed. If your application was rejected for incomplete licensure, you're welcome to reapply once you have a valid license. About Headway We make it easy for mental health providers to take insurance by credentialing you with the nation's largest networks, handling billing and admin paperwork, and helping you earn more stable income with higher rates. With Headway, you can finally focus on what matters most: providing life-changing care. We'll take care of the rest.
Elara Caring is seeking a Social Work Social Worker for a job in Tulsa, Oklahoma. Job Description & Requirements • Specialty: Social Worker • Discipline: Social Work • Duration: Ongoing • Employment Type: Staff At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here, each employee has the chance to make a real difference by carrying out our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right Time, in the Right Place. Job Description: Medical Social Worker - Hospice At Elara Caring, we care where you are and believe the best place for your care is where you live. We know there's no place like home, and that's why our teams continue to provide high-quality care to more than 60,000 patients each day in their preferred home setting. Wherever our patients call home and wherever they are on their journey of health, we care. Each team member has a part to play in this mission. 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