Long Beach, California, United States · On-site
$214k–$418k/yr
JOB DESCRIPTION Job Summary Uses leadership and/or equivalent specialty expertise (transplant, genetics, etc.) to provide advanced clinical managed care / clinical performance. May lead and manage a team of medical direc…
Skills: Clinical Managed Care, Utilization Management, Medical Necessity Review, Prior Authorization, Care Management
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides administrative level support to an Executive and division team members. Prioritizes management/client requests in order to meet business objectives. Supports the day-to-day administra…
Skills: Executive Correspondence, Calendar Management, Meeting Coordination, Research, Report Preparation
Long Beach, California, United States · Hybrid
$26/hr–$51/hr
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Skills: Care Transition, Discharge Planning, Case Management, Patient Education, Motivational Interviewing
Long Beach, California, United States · Remote OK
$96k–$209k/yr
Job Summary Lead enterprise data and analytics transformation initiatives using Databricks and modern cloud technologies. Drive architecture strategy, platform modernization, and solution delivery while partnering with b…
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Long Beach, California, United States · Remote OK
$80k–$157k/yr
***Remote and must live in Texas*** JOB DESCRIPTION Job Summary Responsible for the Management of internal business projects and programs involving department or cross-functional teams of subject matter experts, deliveri…
Skills: Program Management, Project Management, Governance, Strategic Planning, Budget Management
Long Beach, California, United States · On-site
$26/hr–$51/hr
Come join us for our upcoming virtual hiring event! Event Date & Time: Tuesday July 14th at 12:00pm EST Register here today: Florida Care Managers (Miami) & Care Review Clinicians Virtual Hiring Event Event Date & Time: …
Skills: Care Management, Care Coordination, Behavioral Health, Pediatric Care, Comprehensive Assessments
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of …
Skills: Care Management, Care Coordination, Member Assessment, Care Planning, Waiver Enrollment
Long Beach, California, United States · On-site
$24/hr–$46/hr
JOB DESCRIPTION Opportunity for a Texas licensed LVN to join Molina as a Field Care Manager to work with our Medicare members in the service delivery area around Pasadena, TX. You will complete assessments needed for det…
Skills: Care Management, Member Assessments, Care Planning, Case Coordination, Motivational Interviewing
Long Beach, California, United States · On-site
$26/hr–$59/hr
JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to …
Skills: Care Management, Care Coordination, Comprehensive Assessments, Motivational Interviewing, Medication Reconciliation
Long Beach, California, United States · On-site
$26/hr–$51/hr
JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to …
Skills: Care Management, Care Coordination, Comprehensive Assessments, Motivational Interviewing, Medication Reconciliation
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides analyst support for compliance activities. Seeks to ensure the organization adheres to regulatory requirements, industry standards, and Molina internal policies, and prevent and/or de…
Skills: Compliance Management, Corrective Action Plans, Root Cause Analysis, Regulatory Reporting, Data Analysis
Long Beach, California, United States · Remote OK
$29/hr–$56/hr
JOB DESCRIPTION Job Summary This position will offer remote work flexibility, but the individual hired for this role will need to reside in Florida. Provides lead level clinical support to healthcare services team suppor…
Skills: Care Management, Utilization Management, Clinical Support, Case Management, Staff Training
Long Beach, California, United States · Remote OK
$25/hr–$51/hr
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Skills: Utilization Review, Clinical Assessment, Medical Necessity Verification, Prior Authorization, Case Management
Long Beach, California, United States · On-site
$27/hr–$54/hr
JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to …
Skills: Behavioral Health Assessment, Care Coordination, Case Management, Motivational Interviewing, Care Planning
Long Beach, California, United States · On-site
$25/hr–$49/hr
JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to …
Skills: Care Management, Care Coordination, Case Management, Motivational Interviewing, Interdisciplinary Care Team Collaboration
Long Beach, California, United States · On-site
$27/hr–$54/hr
JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to …
Skills: Care Management, Care Coordination, Comprehensive Assessments, Motivational Interviewing, Medication Reconciliation
Long Beach, California, United States · Remote OK
$69k–$143k/yr
***Remote and must live in Iowa*** JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for health plan provider network complex contracting activities. Supports network strategy and development w…
Skills: Contract Negotiation, Value-Based Payment Methodology, Provider Relationship Management, Financial Analysis, Network Adequacy
Long Beach, California, United States · On-site
JOB DESCRIPTION Family Care with My Choice Wisconsin Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team…
Skills: Care Management, Care Coordination, Member Assessment, Care Planning, Waiver Enrollment
Long Beach, California, United States · On-site
JOB DESCRIPTION Family Care with My Choice Wisconsin Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team…
Skills: Care Management, Case Coordination, Member Assessment, Care Planning, Waiver Enrollment
Long Beach, California, United States · Hybrid
$26/hr–$61/hr
JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to …
Skills: Care Management, Care Coordination, Comprehensive Assessments, Motivational Interviewing, Medication Reconciliation
Long Beach, California, United States • On-site
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Provides leadership and clinical expertise to oversee the appropriateness and medical necessity of services provided to members. Manages a team of medical directors to ensure quality, cost-effective care and regulatory compliance.
Requires an MD or DO degree with board certification and an active license in the state of practice. Must have at least 8 years of relevant experience, including 2 years as a medical director in a managed care setting.
JOB DESCRIPTION Job Summary
Uses leadership and/or equivalent specialty expertise (transplant, genetics, etc.) to provide advanced clinical managed care / clinical performance. May lead and manage a team of medical directors delivering oversight and expertise in appropriateness and medical necessity of services provided to members - ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching strategy to provide quality and cost-effective member care.
Position is based in WA
Essential Job Duties
Required Qualifications
• At least 8 years of relevant experience, including clinical practice experience, and at least 2 years as a medical director in managed care setting supporting utilization management/quality management initiatives, or equivalent combination of relevant education and experience.
• Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state of practice.
• Board Certification.
• Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff.
• Demonstrated ability to make strategic decisions.
• Knowledge of health care regulatory and legislative processes, including ability to read and interpret legislation.
• Experience gaining consensus and collaborating in a highly matrixed organization.
• Experience demonstrating strong leadership, communication, consensus building, collaboration and financial acumen abilities.
• Evidence-based clinical criteria competency.
• Peer review, medical policy/procedure development, and provider contracting experience.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
• At least 3 years management/leadership experience.
• Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other Health care 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
Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care. Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.
Offices: 200 Oceangate, Long Beach, California 90802, US
Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care. Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.
Offices: 200 Oceangate, Long Beach, California 90802, US
