JOB DESCRIPTION

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.

The Program Manager (BH) is responsible for overseeing internal business projects and programs related to Behavioral Health Operations. The role involves collaboration with cross functional teams, managing timelines and ensuring successful project delivery from inception to completion. The Behavioral Health Program Manager will also engage with external vendors and serve as the Behavioral Health subject matter expert for the health plan.

KNOWLEDGE/SKILLS/ABILITIES

In collaboration with others, 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. Manages programs providing ongoing communication of goals, evaluation, and support to ensure compliance with standardized protocols and processes. May engage and evaluate the work of external vendors as well as identify community-based organizations for partnership to meet program needs. Establish key performance indicators (KPIs) and monitor clinical outcomes of program participants to assess program performance and inform decision-making. Contribute to the strategic planning process by identifying emerging trends and innovative approaches in behavioral health care. Focuses on process improvement, organizational change management, program management and other processes relative to the business. Serves as a subject matter expert and leads programs to meet critical needs. Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements. Works with operational leaders within the business to provide recommendations for process improvement opportunities. Conducts quality audits to assess Molina Healthcare Services staff educational needs and service quality and implement quality initiatives within the department as appropriate. Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.

JOB QUALIFICATIONS

Required Education

Registered Nurse or equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license OR Licensed Clinical Social Worker (LCSW), License Professional Counselor (LCPC), or Licensed Marriage and Family Therapist (LMFT) OR Bachelor's or Master’s degree in Nursing, Gerontology, Public Health, Social Work or related field.

Required Experience

3+ years of managed healthcare experience, including 1 or more years in one or more of the following areas: utilization management, case management, care transition and/or disease management. 2+ years of program and/or project management experience. 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. Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

Preferred Education

Master's Degree preferred.

Preferred Experience

Medicaid/Medicare Population experience with increasing responsibility. 3+ years of clinical experience in behavioral health.

Preferred License, Certification, Association

Any of the following:

PMP, Six Sigma Green Belt and/or comparable coursework desired. 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 intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.