Dir, Healthcare Services (Pediatric Population Health/CA) - Military Veterans
at Molina Healthcare
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 Director of Pediatric Population Health will be responsible for the oversight and strategy of Early and Periodic Screening Diagnosis, and Treatment. This includes ensuring that the dashboard is accurately reflecting the data and ensuring that there is a strategy in place to improve priority metrics with a reporting mechanism to the Health Care Services Committee each quarter. The Director of Pediatric Population Health will also oversee the school based health strategy development and execution as well as oversee the Memorandum Of Understanding execution and partnership with the Local Education Agencies in the five counties that Molina serves. This role will also oversee dental coordination and relationship management with our dental vendors, Maternal Health which includes Comprehensive Perinatal Services Program, the WIC Memorandums of Understanding and relationship in each county, and the Doula Program and strategy.
KNOWLEDGE/SKILLS/ABILITIES
- Directs and oversees one of the following key Healthcare Services functions: Pediatric Population Health case management/disease management/care transitions; utilization management (Position oversees PA authorizations and manages the inpatient certification review staff for initial, concurrent, or retrospective reviews); long-term supports and services; or nurse advice line.
- Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care review and management.
- Develops, performs, and promotes interdepartmental integration and collaboration to enhance clinical services.
- Collaborates with and keeps the AVP or VP of Healthcare Services informed of operational issues, staffing, resources, system, and program needs and presents solution action plan for issues.
- Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote standardized Molina enterprise-wide approach to Care Management programs in Ca.
- Ensures monthly auditing is occurring with appropriate follow-up.
- Engaged in clinical training activities and outcomes.
- Develops and mentors HCS managers and supervisors.
- This a full-time position, based in California.
JOB QUALIFICATIONS
Required Education
Bachelor's Degree in Healthcare-related field (equivalent combination of education, experience and/or Nursing license will be considered in lieu of Bachelor's Degree).
Required Experience
- 7+ years managed healthcare experience with line management responsibility including clinical operations (Medi-Cal).
- Experience working within applicable state (CA), federal, and third-party regulations (Medi-Cal).
Required License, Certification, Association
If licensed, license must be active, unrestricted and in good standing.
Preferred Education
Master's Degree in Business, Healthcare, Social Work, or related field.
Preferred Experience
- Experience working with Pediatric Populations (MediCal)
- Population Health experience
- Experience with and knowledge of CA capitation / delegated business model.
Preferred License, Certification, Association
- Active, unrestricted State Registered Nursing (RN) license in good standing.
- Utilization 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: $101,721 - $198,356 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
CA
Molina believes every person, family and community deserves access to high-quality health care regardless of their situation. Our mission is to deliver effective, reliable and affordable health care to those who need it most. We strive to meet the physical, social and emotional needs of each member and to strengthen the communities we serve.
We do this by offering a holistic, community-based approach designed specifically to meet the individual needs of our members.
What started in 1980 as one clinic in Long Beach, aimed at addressing the disparities in access to quality health care, has grown into 19 health plans across the country. For over 40-years we’ve been improving the lives of our 5.1 million members across the country by pioneering health care services exclusively for those with government-sponsored health care.
As our membership has grown over the years, so has our commitment to the communities we serve. In 2020, we launched the MolinaCares Accord, which makes substantial investments to improve members’ access to health care.