Supervisor, Care Coordination

2 weeks ago

Long Beach, California, United States Molina Healthcare Full time
Job Overview

POSITION SUMMARY

Role Overview

Molina Healthcare Services (HCS) collaborates with members, healthcare providers, and a multidisciplinary team to evaluate, facilitate, plan, and coordinate a comprehensive delivery of care across various settings, including behavioral health and long-term care, for members with significant healthcare needs. HCS personnel strive to ensure that patients progress towards their desired health outcomes through quality care that is both medically appropriate and cost-effective, tailored to the severity of their condition and the care setting.

KEY RESPONSIBILITIES

Leads an integrated Care Management team responsible for case management, community engagement, health management, and transition of care initiatives to support Molina Healthcare members in meeting their healthcare objectives. The Care Management team aims to assist members in achieving optimal clinical, financial, and quality of life outcomes, including safe and effective transitions from acute or inpatient care to lower levels of care or home settings in a cost-efficient manner.
  • Acts as a proactive supervisor, providing direction and support to the care management team to ensure the execution of activities that align with the care model and adhere to regulatory standards.
  • Oversees staff caseloads and appropriately assigns cases based on the complexity of medical or psychosocial needs and the experience level of case managers (RN, LSW, or other allied health professionals).
  • Ensures compliance with standard Molina processes and HIPAA by overseeing the staff's use of the electronic case management documentation system, arranging training as necessary.
  • Manages, mentors, and evaluates team members' performance; fosters employee development and recognition; assists in the selection, orientation, and mentoring of new hires.
  • Encourages multidisciplinary collaboration, provider outreach, and the involvement of family and caregivers to enhance continuity of care for Molina members. Participates in Interdisciplinary Care Team meetings.
  • Collaborates with management to ensure adequate staffing and service levels while maintaining customer satisfaction through the implementation and monitoring of staff productivity and performance metrics.
  • Conducts audits of case management assessments and care plan development for completeness and timeliness in accordance with state regulations.
  • Monitors hospital discharge visits and post-discharge follow-ups to ensure continuity of care and minimize unnecessary readmissions.
  • May oversee the completeness of the Transition of Care (ToC) assessment and ensure timely contact per ToC protocols.
QUALIFICATIONS

Required Education
  • Registered Nurse or an equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) with relevant experience in lieu of RN licensure.
  • OR a Bachelor's or Master's degree in gerontology, public health, or social work with applicable case management experience.
Required Experience

A minimum of 3 years in case management, disease management, managed care, or medical or behavioral health environments.

Required License, Certification, Association

If licensed, the license must be active, unrestricted, and in good standing.

Preferred Education

Bachelor's or Master's degree in Nursing.

Preferred Experience

Over five years of experience in Case Management, with a focus on Medicaid/Medicare populations and increasing responsibilities.

Preferred License, Certification, Association

Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), or other relevant healthcare or management certifications.

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

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