Supervisor Care Management Remote in New York Job at Molina Healthcare
Molina Healthcare New York, NY
$66,456 - $129,589 a year
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.
This position will support our Senior Whole Health business. Senior Whole Health by Molina is a Managed Long-Term Care (MLTC), and Medicaid Advantage (MAP) plan. These plans streamline the delivery of long-term services to chronically ill or disabled people who are eligible for Medicaid and Medicare. We are looking for a Supervisor, Care Management with strong leadership and managed care experience. The Supervisor, Care Management must have the ability to work in a high-volume environment and manage external vendors. Experience with Managed Long Term Care experience (MLTC) is highly preferred.
KNOWLEDGE/SKILLS/ABILITIES
Oversees an integrated Care Management team responsible for case management, community connectors, health management, and/or transition of care activities to assist Molina Healthcare members with their healthcare needs. Care Management staff work to help members achieve optimal clinical, financial and quality of life outcomes, including safely and effectively transitioning Molina members from acute or inpatient care to lower levels of care and/or home in a cost-efficient manner.
Functions as a hands-on supervisor, providing direction and guidance to the care management team to ensure implementation of activities that align with the model of care and that meet regulatory requirements.
Manages staff caseloads and assigns cases appropriately regarding complexity of medical or psychosocial needs and case manager experience (RN, LSW, other allied fields).
Oversees the staff use of the electronic case management documentation system in compliance with standard Molina processes, standard documentation styles, and HIPAA. Arranges training as needed.
Manages, coaches and evaluates the performance of team members; provides employee development and recognition; and assists with selection, orientation and mentoring of new staff.
Promotes multidisciplinary collaboration, provider outreach, and engagement of family and caregivers to enhance the continuity of care for Molina members. Oversees and/or participates in Interdisciplinary Care Team meetings.
Works with the Manager to ensure adequate staffing and service levels and maintains customer satisfaction by implementing and monitoring staff productivity and performance indicators.
Audits case management assessments and care plan development for completeness and timeliness according to state requirements.
Monitors onsite hospital discharge visits and post-discharge visits to assure continuity of care and prevent unnecessary readmissions.
May monitor the completeness of the Transition of Care (ToC) assessment and the timeframes for contact are per ToC protocols.
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 Bachelor's or master’s degree in gerontology, public health, or social work with related case management experience.
Required Experience
3 or more years in case management, disease management, managed care or medical or behavioral health settings.
Required License, Certification, Association
If licensed, license must be active, unrestricted and in good standing.
Preferred Education
Bachelor's or master’s degree in Nursing,
Preferred Experience
More than five years Case Management experience. Medicaid/Medicare Population experience with increasing responsibility.
Leadership experience
Experience managing external vendors
Licensure: RN, LNP, LCSW or LMSW
Proficient with technology
Preferred License, Certification, Association
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.
Pay Range: $66,456 - $129,589 a year*
Please Note :
ajayjain.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, ajayjain.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.
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.
This position will support our Senior Whole Health business. Senior Whole Health by Molina is a Managed Long-Term Care (MLTC), and Medicaid Advantage (MAP) plan. These plans streamline the delivery of long-term services to chronically ill or disabled people who are eligible for Medicaid and Medicare. We are looking for a Supervisor, Care Management with strong leadership and managed care experience. The Supervisor, Care Management must have the ability to work in a high-volume environment and manage external vendors. Experience with Managed Long Term Care experience (MLTC) is highly preferred.
KNOWLEDGE/SKILLS/ABILITIES
Oversees an integrated Care Management team responsible for case management, community connectors, health management, and/or transition of care activities to assist Molina Healthcare members with their healthcare needs. Care Management staff work to help members achieve optimal clinical, financial and quality of life outcomes, including safely and effectively transitioning Molina members from acute or inpatient care to lower levels of care and/or home in a cost-efficient manner.
Functions as a hands-on supervisor, providing direction and guidance to the care management team to ensure implementation of activities that align with the model of care and that meet regulatory requirements.
Manages staff caseloads and assigns cases appropriately regarding complexity of medical or psychosocial needs and case manager experience (RN, LSW, other allied fields).
Oversees the staff use of the electronic case management documentation system in compliance with standard Molina processes, standard documentation styles, and HIPAA. Arranges training as needed.
Manages, coaches and evaluates the performance of team members; provides employee development and recognition; and assists with selection, orientation and mentoring of new staff.
Promotes multidisciplinary collaboration, provider outreach, and engagement of family and caregivers to enhance the continuity of care for Molina members. Oversees and/or participates in Interdisciplinary Care Team meetings.
Works with the Manager to ensure adequate staffing and service levels and maintains customer satisfaction by implementing and monitoring staff productivity and performance indicators.
Audits case management assessments and care plan development for completeness and timeliness according to state requirements.
Monitors onsite hospital discharge visits and post-discharge visits to assure continuity of care and prevent unnecessary readmissions.
May monitor the completeness of the Transition of Care (ToC) assessment and the timeframes for contact are per ToC protocols.
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 Bachelor's or master’s degree in gerontology, public health, or social work with related case management experience.
Required Experience
3 or more years in case management, disease management, managed care or medical or behavioral health settings.
Required License, Certification, Association
If licensed, license must be active, unrestricted and in good standing.
Preferred Education
Bachelor's or master’s degree in Nursing,
Preferred Experience
More than five years Case Management experience. Medicaid/Medicare Population experience with increasing responsibility.
Leadership experience
Experience managing external vendors
Licensure: RN, LNP, LCSW or LMSW
Proficient with technology
Preferred License, Certification, Association
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.
Pay Range: $66,456 - $129,589 a year*
- Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Please Note :
ajayjain.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, ajayjain.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.