- Directs and oversees one of the following key Healthcare Services functions: 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.
- 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.
- 7+ years managed healthcare experience with line management responsibility including clinical operations.
- Experience working within applicable state, federal, and third-party regulations.
- 10+ years managed care experience.
- Operational and process improvement experience.
- 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
-
Mgr, Healthcare Services
4 days ago
Molina Healthcare San Antonio, United StatesJOB 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 ...
-
Healthcare Customer Service Rep
1 day ago
Carenet Health San Antonio, United StatesOverview: · At Carenet, we foster collaboration, creativity and innovation. Our promises to our team members include empowering growth through trust, opportunity and accountability. We are looking for people who want to work with an entrepreneurial spirit and deliver market-lead ...
-
Healthcare Customer Service Specialist
1 week ago
Equity Staffing Group San Antonio, United StatesEquity Staffing is searching for a Healthcare Customer Service Specialist In San Antonio, TX. This position is with a Fortune 500 organization. Our client serves more than 85 million people and has a reputation for bold ideas. If you enjoy working with energetic people in a colla ...
-
HealthLink (Fitness Center) San Antonio, United States Full time**Up to $6,000 Sign-On bonus for experienced Patient Care Associate / PCA** · **Summary** · Patient Services Representative Under the direction/supervision of an RN, provides basic nursing care for assigned group of patients · General Nursing Units PSR cares for patients from age ...
-
Nurse Manager of Med Surg Oncology
6 days ago
Methodist Hospital San Antonio, United States**Introduction**: · Do you have the career opportunities as a(an) Nurse Manager of Med Surg Oncology you want with your current employer? We have an exciting opportunity for you to join Methodist Hospital which is part of the nation's leading provider of healthcare services, HCA ...
-
Registered Nurse Surgery Per Diem Days NBH
1 week ago
Northeast Baptist Hospital San Antonio, United States Full timeSummary · Under minimal supervision, provides professional nursing care for patients ranging in age from newborn to geriatric, within the nurse's competencies following established standards and practices. Supports the mission statement, policies and procedures of the Baptist Hea ...
-
Registered Nurse Surgery Full Time Days NBH
2 days ago
Northeast Baptist Hospital San Antonio, United States Full timeUp to $20,000 Sign On Bonus available based on experience · Summary · Under minimal supervision, provides professional nursing care for patients ranging in age from newborn to geriatric, within the nurse's competencies following established standards and practices. Supports the m ...
-
North Central Baptist Hospitals San Antonio, United States Full time**Up to $6,000 Sign-On bonus for experienced Patient Care Associate / PCA** · **Position Summary** · Under the direction/supervision of an RN, provides basic nursing care for assigned group of patients · General Nursing Units cares for patients from age 15 years to maturity by cl ...
-
Registered Nurse Rn Med Surg Ortho
6 days ago
Methodist Hospital San Antonio, United States**Introduction**:** Do you want to be appreciated daily? Our nurses are celebrated for being on the front line, empathetic for patients. At Methodist Hospital our nurses set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Ortho Surgical to join ...
-
Baptist Medical Center San Antonio, United States Full time**Up to $20,000 Sign-On bonus based on experience** · **Summary** · Under mínimal supervision, provides professional nursing care for patients ranging in age from newborn to geriatric, within the nurse's competencies following established standards and practices. Supports the mis ...
-
Quality Control Technician
2 days ago
Actalent San Antonio, United States Full timeActalent is currently hiring a Quality Control Technician in San Antonio, TX · Job Description: · Follow SOP process · Inspect finished products · Document results · Quality testing of finished products · Visual inspection of products · Shift Available: Monday - Friday, 6pm - 2:3 ...
-
Saint Luke's Hospital San Antonio, United States Full time**Up to $3,000 Sign On Bonus available based on experience** · *** · Responsible for the general cleanliness of the following areas at the Medical Facilities: Procedure areas, Wound Care, Emergency Department, GI Lab, Intensive Care Unit patient care areas, rest rooms, and all ot ...
-
Rn, Registered Nurse
6 days ago
CHRISTUS Health San Antonio, United States**Summary**: · The competent Nurse, in the same or similar clinical setting, practices independently and demonstrates an awareness of all relevant aspects of a situation. Provides routine and complex care, with the ability to on long-range goals or plans. Continues to develop the ...
-
Quality Control Technician
2 days ago
Actalent San Antonio, United States Full timeQuality Control Technician · Description: · The Quality Control Technician is responsible for monitoring, documenting, and enforcing policies as well as training key team members and taking critical corrective action when required. The technician role is a hands on role in a fas ...
-
CACI Bear, United StatesDHS Credentialed/Experienced Background Investigator · Job Category: Service Contract Act · Time Type: Full time · Minimum Clearance Required to Start: Top Secret · Employee Type: Regular · Percentage of Travel Required: Up to 10% · Type of Travel: Local · - * · CACI Premier Tech ...
-
Director of Cath Lab
6 days ago
HumanRek Trading San Antonio, United States**Position Summary**: Responsible for the oversight and management of the Cardiovascular Services Department; works with patients from adolescent to geriatric. Completes established competencies for the position within designated introductory period. Other related duties as assig ...
-
Jr. Scrum Master
6 days ago
HII San Antonio, United StatesEnlighten, honored as a Top Workplace from the Baltimore Sun, is a leader in big data solution development and deployment, with expertise in cloud-based services, software and systems engineering, cyber capabilities, and data science. Enlighten provides continued innovation and p ...
-
Director of Finance and Accounting
6 days ago
Hispanic Association of Colleges and Universities San Antonio, United States: · **SUMMARY** · The Director of Finance and Accounting assists with the establishment and implementation of the organization's accounting policies and procedures. They will have overall responsibility for assigned accounting operations and systems as well as associated analysis ...
-
Development Coordinator
6 days ago
Hispanic Association of Colleges and Universities San Antonio, United States: · **SUMMARY** · The position will support needs of the Development Department, which includes the Executive Director of Development and Development Directors for Partnerships and Foundations and Annual Giving, with a focus on assisting in the coordination and facilitation of de ...
-
Registered Dietitian
4 days ago
RD Nutrition Consultants San Antonio, United StatesClinical Registered Dietitian Position - Part-Time/Hybrid · Company: RD Nutrition Consultants LLC · Overview: RD Nutrition Consultants LLC is excited to offer an opportunity for a Clinical Registered Dietitian to join our team. This role allows flexibility and a balanced blend o ...
Dir, Healthcare Services - San Antonio, TX, United States - Molina Healthcare
Description
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.
KNOWLEDGE/SKILLS/ABILITIES
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
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
Preferred License, Certification, Association
#PJHS
#LI-AC1
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: $79, $172,483.8 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Dir, Healthcare Services professionals in San Antonio
-
briana paredes
College Student
-
Magdalena Canas
Psychiatric Mental Health Nurse Practitioner-BC
-
Rebecca Miranda
Health Services Manager
-
Anastasia Gutierrez
Growth and development
-
Ingrid Glueck-Maldonado
Chief Financial Officer
-
Jaime Contreras, MBA, CISM, CISA
IT Security Specialist