Finance Services Director jobs at HCA Healthcare - 60 jobs

Leads and directs team responsible for finance activities including financial analysis, reporting, forecasting, trending and modeling. Duties include interpreting and evaluating information for future business decisions such as new product development, marketing strategies and investments, financial regulations, and similar financial projects or programs. **Essential Job Duties** + Prepare schedules and worksheets for the Plan's regulatory financial reporting requirements. + Coordinate, research and respond to follow-up questions from state and federal regulators. + Oversite of encounters to financial reporting reconciliations on state required basis. + Prepares short-term and long-term financial strategic plans per corporate guidelines. + Hires, onboards, trains, mentors, develops and manages finance staff performance. + Coordinates the month-end close with accounting staff. Supports review of all non-IBNR reserves for appropriateness on a monthly basis. + Gathers, interprets and evaluates financial information; generating forecasts and analyzing trends in sales, finance and other areas of business. + Uses financial data to evaluate and make recommendations relating to business opportunities, product development, marketing strategies, investments, financial regulations, and similar financial projects or programs. **Required Qualifications** + At least 8 years of finance experience, or equivalent combination of relevant education and experience. + At least 3 years management/leadership experience. + Bachelor's degree in accounting, finance, business administration, math or related field. + Strong critical-thinking and attention to detail. + Ability to effectively collaborate with technical and non-technical stakeholders. + Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. + Excellent verbal and written communication skills. + Proficient in Microsoft Office suite products, including advanced skills in Excel (VLOOKUPs and pivot tables), and applicable software program(s) proficiency. **Preferred Qualifications** + Certified Public Accountant (CPA) To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V \#PJCorp \#LI-AC1 Pay Range: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Leads and directs team responsible for finance activities including financial analysis, reporting, forecasting, trending and modeling. Duties include interpreting and evaluating information for future business decisions such as new product development, marketing strategies and investments, financial regulations, and similar financial projects or programs. **Essential Job Duties** + Prepare schedules and worksheets for the Plan's regulatory financial reporting requirements. + Coordinate, research and respond to follow-up questions from state and federal regulators. + Oversite of encounters to financial reporting reconciliations on state required basis. + Prepares short-term and long-term financial strategic plans per corporate guidelines. + Hires, onboards, trains, mentors, develops and manages finance staff performance. + Coordinates the month-end close with accounting staff. Supports review of all non-IBNR reserves for appropriateness on a monthly basis. + Gathers, interprets and evaluates financial information; generating forecasts and analyzing trends in sales, finance and other areas of business. + Uses financial data to evaluate and make recommendations relating to business opportunities, product development, marketing strategies, investments, financial regulations, and similar financial projects or programs. **Required Qualifications** + At least 8 years of finance experience, or equivalent combination of relevant education and experience. + At least 3 years management/leadership experience. + Bachelor's degree in accounting, finance, business administration, math or related field. + Strong critical-thinking and attention to detail. + Ability to effectively collaborate with technical and non-technical stakeholders. + Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. + Excellent verbal and written communication skills. + Proficient in Microsoft Office suite products, including advanced skills in Excel (VLOOKUPs and pivot tables), and applicable software program(s) proficiency. **Preferred Qualifications** + Certified Public Accountant (CPA) To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V \#PJCorp \#LI-AC1 Pay Range: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Leads and directs team responsible for finance activities including financial analysis, reporting, forecasting, trending and modeling. Duties include interpreting and evaluating information for future business decisions such as new product development, marketing strategies and investments, financial regulations, and similar financial projects or programs. **Essential Job Duties** + Prepare schedules and worksheets for the Plan's regulatory financial reporting requirements. + Coordinate, research and respond to follow-up questions from state and federal regulators. + Oversite of encounters to financial reporting reconciliations on state required basis. + Prepares short-term and long-term financial strategic plans per corporate guidelines. + Hires, onboards, trains, mentors, develops and manages finance staff performance. + Coordinates the month-end close with accounting staff. Supports review of all non-IBNR reserves for appropriateness on a monthly basis. + Gathers, interprets and evaluates financial information; generating forecasts and analyzing trends in sales, finance and other areas of business. + Uses financial data to evaluate and make recommendations relating to business opportunities, product development, marketing strategies, investments, financial regulations, and similar financial projects or programs. **Required Qualifications** + At least 8 years of finance experience, or equivalent combination of relevant education and experience. + At least 3 years management/leadership experience. + Bachelor's degree in accounting, finance, business administration, math or related field. + Strong critical-thinking and attention to detail. + Ability to effectively collaborate with technical and non-technical stakeholders. + Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. + Excellent verbal and written communication skills. + Proficient in Microsoft Office suite products, including advanced skills in Excel (VLOOKUPs and pivot tables), and applicable software program(s) proficiency. **Preferred Qualifications** + Certified Public Accountant (CPA) To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V \#PJCorp \#LI-AC1 Pay Range: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Leads and directs team responsible for finance activities including financial analysis, reporting, forecasting, trending and modeling. Duties include interpreting and evaluating information for future business decisions such as new product development, marketing strategies and investments, financial regulations, and similar financial projects or programs. **Essential Job Duties** + Prepare schedules and worksheets for the Plan's regulatory financial reporting requirements. + Coordinate, research and respond to follow-up questions from state and federal regulators. + Oversite of encounters to financial reporting reconciliations on state required basis. + Prepares short-term and long-term financial strategic plans per corporate guidelines. + Hires, onboards, trains, mentors, develops and manages finance staff performance. + Coordinates the month-end close with accounting staff. Supports review of all non-IBNR reserves for appropriateness on a monthly basis. + Gathers, interprets and evaluates financial information; generating forecasts and analyzing trends in sales, finance and other areas of business. + Uses financial data to evaluate and make recommendations relating to business opportunities, product development, marketing strategies, investments, financial regulations, and similar financial projects or programs. **Required Qualifications** + At least 8 years of finance experience, or equivalent combination of relevant education and experience. + At least 3 years management/leadership experience. + Bachelor's degree in accounting, finance, business administration, math or related field. + Strong critical-thinking and attention to detail. + Ability to effectively collaborate with technical and non-technical stakeholders. + Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. + Excellent verbal and written communication skills. + Proficient in Microsoft Office suite products, including advanced skills in Excel (VLOOKUPs and pivot tables), and applicable software program(s) proficiency. **Preferred Qualifications** + Certified Public Accountant (CPA) To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V \#PJCorp \#LI-AC1 Pay Range: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Leads and directs team responsible for finance activities including financial analysis, reporting, forecasting, trending and modeling. Duties include interpreting and evaluating information for future business decisions such as new product development, marketing strategies and investments, financial regulations, and similar financial projects or programs. **Essential Job Duties** + Prepare schedules and worksheets for the Plan's regulatory financial reporting requirements. + Coordinate, research and respond to follow-up questions from state and federal regulators. + Oversite of encounters to financial reporting reconciliations on state required basis. + Prepares short-term and long-term financial strategic plans per corporate guidelines. + Hires, onboards, trains, mentors, develops and manages finance staff performance. + Coordinates the month-end close with accounting staff. Supports review of all non-IBNR reserves for appropriateness on a monthly basis. + Gathers, interprets and evaluates financial information; generating forecasts and analyzing trends in sales, finance and other areas of business. + Uses financial data to evaluate and make recommendations relating to business opportunities, product development, marketing strategies, investments, financial regulations, and similar financial projects or programs. **Required Qualifications** + At least 8 years of finance experience, or equivalent combination of relevant education and experience. + At least 3 years management/leadership experience. + Bachelor's degree in accounting, finance, business administration, math or related field. + Strong critical-thinking and attention to detail. + Ability to effectively collaborate with technical and non-technical stakeholders. + Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. + Excellent verbal and written communication skills. + Proficient in Microsoft Office suite products, including advanced skills in Excel (VLOOKUPs and pivot tables), and applicable software program(s) proficiency. **Preferred Qualifications** + Certified Public Accountant (CPA) To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V \#PJCorp \#LI-AC1 Pay Range: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Leads and directs team responsible for finance activities including financial analysis, reporting, forecasting, trending and modeling. Duties include interpreting and evaluating information for future business decisions such as new product development, marketing strategies and investments, financial regulations, and similar financial projects or programs. Essential Job Duties Prepare schedules and worksheets for the Plan's regulatory financial reporting requirements. Coordinate, research and respond to follow-up questions from state and federal regulators. Oversite of encounters to financial reporting reconciliations on state required basis. Prepares short-term and long-term financial strategic plans per corporate guidelines. Hires, onboards, trains, mentors, develops and manages finance staff performance. Coordinates the month-end close with accounting staff. Supports review of all non-IBNR reserves for appropriateness on a monthly basis. Gathers, interprets and evaluates financial information; generating forecasts and analyzing trends in sales, finance and other areas of business. Uses financial data to evaluate and make recommendations relating to business opportunities, product development, marketing strategies, investments, financial regulations, and similar financial projects or programs. Required Qualifications At least 8 years of finance experience, or equivalent combination of relevant education and experience. At least 3 years management/leadership experience. Bachelor's degree in accounting, finance, business administration, math or related field. Strong critical-thinking and attention to detail. Ability to effectively collaborate with technical and non-technical stakeholders. Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. Excellent verbal and written communication skills. Proficient in Microsoft Office suite products, including advanced skills in Excel (VLOOKUPs and pivot tables), and applicable software program(s) proficiency. Preferred Qualifications Certified Public Accountant (CPA) To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Leads and directs team responsible for finance activities including financial analysis, reporting, forecasting, trending and modeling. Duties include interpreting and evaluating information for future business decisions such as new product development, marketing strategies and investments, financial regulations, and similar financial projects or programs. **Essential Job Duties** + Prepare schedules and worksheets for the Plan's regulatory financial reporting requirements. + Coordinate, research and respond to follow-up questions from state and federal regulators. + Oversite of encounters to financial reporting reconciliations on state required basis. + Prepares short-term and long-term financial strategic plans per corporate guidelines. + Hires, onboards, trains, mentors, develops and manages finance staff performance. + Coordinates the month-end close with accounting staff. Supports review of all non-IBNR reserves for appropriateness on a monthly basis. + Gathers, interprets and evaluates financial information; generating forecasts and analyzing trends in sales, finance and other areas of business. + Uses financial data to evaluate and make recommendations relating to business opportunities, product development, marketing strategies, investments, financial regulations, and similar financial projects or programs. **Required Qualifications** + At least 8 years of finance experience, or equivalent combination of relevant education and experience. + At least 3 years management/leadership experience. + Bachelor's degree in accounting, finance, business administration, math or related field. + Strong critical-thinking and attention to detail. + Ability to effectively collaborate with technical and non-technical stakeholders. + Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. + Excellent verbal and written communication skills. + Proficient in Microsoft Office suite products, including advanced skills in Excel (VLOOKUPs and pivot tables), and applicable software program(s) proficiency. **Preferred Qualifications** + Certified Public Accountant (CPA) To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V \#PJCorp \#LI-AC1 Pay Range: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs. * Facilitates behavioral health-related regional medical necessity reviews and cross coverage. * Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses. * Responds to behavioral health-related requests for proposal (RFP) sections and reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric diagnoses and treatment. * Provides second level behavioral health clinical reviews, peer reviews and appeals. * Supports behavioral health committees for quality compliance. * Implements behavioral health specific clinical practice guidelines and medical necessity review criteria. * Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the recruitment and orientation of new psychiatric medical directors. * Ensures all behavioral health programs and policies are in line with industry standards and best practices. * Assists with new program implementation and supports for health plan in-source behavioral health services. Required Qualifications * At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry/behavioral health, or equivalent combination of relevant education and experience. * Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state (NY) of practice. * Board Certification in Psychiatry. * Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff. * Ability to work cross-collaboratively within a highly matrixed organization. * Strong organizational and time-management skills. * Ability to multi-task and meet deadlines. * Attention to detail. * Critical-thinking and active listening skills. * Decision-making and problem-solving skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $186,201.39 - $363,093 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

**Per Diem Hospice Medical Directorin Beautiful Northern, CO** **Remote Only & Flexible Schedule** **BANNER HEALTH and the Home Care & Hospice Division** , one of the countrys premier, nonprofit health care networks with more than 1,500 physicians and advance practice providers, **has an excellent opportunity for a compassionate, skilled clinician to join our interdisciplinary team! This position serves the growing community in Northern Colorado in partnership with the current care team.** Utilizing a multidisciplinary approach, the qualified candidate will provide remote support to the Home Care & Hospice team of Advanced Practice Providers. **Position Requirements and Information:** + BC/BE in a relevant specialty + Colorado state licensed + Fellowship training in Hospice & Palliative Medicine - NOT REQUIRED + Experience preferred, new graduates also welcome to apply + Flexible schedule primarily providing back-up coverage for the acting Medical Director **Compensation & Benefits:** + **$140/hr** + Malpractice and Tail Coverage **About the area:** With more than 300 days of sunshine, Northern Colorado is one of the best places to live and work offering spectacular views along the Rocky Mountain Front Range, great weather, endless recreational activities, cultural amenities, education, and professional opportunities. + Within one hour of majestic Rocky Mountain National Park & 90 minutes to world-class ski resorts + Numerous outdoor activities including golf, biking, hiking, camping, rock climbing, hunting, and fishing + Thriving cultural and retail sectors + Highly educated workforce & broad-based business sector leading to substantial growth along the front range + Variety of public and private education options for K-12 and easy access to three major universities **PLEASE SUBMIT YOUR CV TODAY FOR IMMEDIATE CONSIDERATION** As an equal opportunity employer, Banner Health values culture and encourages applications from individuals with varied experiences and backgrounds. Banner Health is an EEO Employer. POS15101 Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability.

Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions: utilization management, care management, behavioral health and other programs. Leads team responsible for assessing, facilitating, planning and coordinating integrated delivery of care across the continuum. Participates with senior leadership to establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care. This role will support operational needs 5am - 7pm PST. Working hours may vary and coverage will include Mon. - Sat. and some Holidays. Essential Job Duties - Directs and oversees one or more of the following key health care services functions: care management, utilization management, care transitions, long-term supports and services (LTSS), behavioral health, nurse advice line, and/or other special programs. - Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care coordination/care review and management. - Develops and promotes interdepartmental integration and collaboration to enhance clinical services. - Collaborates with and keeps healthcare services senior leadership informed of operational issues, staffing, resources, system and program needs and presents solutions/action plans for issues. - Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote a standardized enterprise-wide approach to healthcare services programs. - Ensures monthly auditing is occurring with appropriate follow-up. - Engages in clinical training activities and outcomes. - Develops and mentors direct reporting healthcare services leadership. - Local travel may be required (based upon state/contractual requirements). Required Qualifications -At least 8 years health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience. - At least 3 years health care management/leadership required. - Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. - Experience working within applicable state, federal, and third party regulations. - Ability to manage conflict and lead through change. - Operational and process improvement experience. - Ability to work cross-collaboratively across a highly matrixed organization. - Ability to prioritize and manage multiple deadlines. - Excellent organizational, problem-solving and critical-thinking skills. - Strong written and verbal communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Registered Nurse (RN). License must be active and unrestricted in state of practice. - Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification. - Medicaid/Medicare population experience. - Clinical experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $88,453 - $206,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions: utilization management, care management, behavioral health and other programs. Leads team responsible for assessing, facilitating, planning and coordinating integrated delivery of care across the continuum. Participates with senior leadership to establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care. This role will support operational needs 5am - 7pm PST. Working hours may vary and coverage will include Mon. - Sat. and some Holidays. Essential Job Duties - Directs and oversees one or more of the following key health care services functions: care management, utilization management, care transitions, long-term supports and services (LTSS), behavioral health, nurse advice line, and/or other special programs. - Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care coordination/care review and management. - Develops and promotes interdepartmental integration and collaboration to enhance clinical services. - Collaborates with and keeps healthcare services senior leadership informed of operational issues, staffing, resources, system and program needs and presents solutions/action plans for issues. - Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote a standardized enterprise-wide approach to healthcare services programs. - Ensures monthly auditing is occurring with appropriate follow-up. - Engages in clinical training activities and outcomes. - Develops and mentors direct reporting healthcare services leadership. - Local travel may be required (based upon state/contractual requirements). Required Qualifications -At least 8 years health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience. - At least 3 years health care management/leadership required. - Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. - Experience working within applicable state, federal, and third party regulations. - Ability to manage conflict and lead through change. - Operational and process improvement experience. - Ability to work cross-collaboratively across a highly matrixed organization. - Ability to prioritize and manage multiple deadlines. - Excellent organizational, problem-solving and critical-thinking skills. - Strong written and verbal communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Registered Nurse (RN). License must be active and unrestricted in state of practice. - Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification. - Medicaid/Medicare population experience. - Clinical experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $88,453 - $206,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs. * Facilitates behavioral health-related regional medical necessity reviews and cross coverage. * Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses. * Responds to behavioral health-related requests for proposal (RFP) sections and reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric diagnoses and treatment. * Provides second level behavioral health clinical reviews, peer reviews and appeals. * Supports behavioral health committees for quality compliance. * Implements behavioral health specific clinical practice guidelines and medical necessity review criteria. * Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the recruitment and orientation of new psychiatric medical directors. * Ensures all behavioral health programs and policies are in line with industry standards and best practices. * Assists with new program implementation and supports for health plan in-source behavioral health services. Required Qualifications * At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry/behavioral health, or equivalent combination of relevant education and experience. * Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state (NY) of practice. * Board Certification in Psychiatry. * Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff. * Ability to work cross-collaboratively within a highly matrixed organization. * Strong organizational and time-management skills. * Ability to multi-task and meet deadlines. * Attention to detail. * Critical-thinking and active listening skills. * Decision-making and problem-solving skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $186,201.39 - $363,093 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions: utilization management, care management, behavioral health and other programs. Leads team responsible for assessing, facilitating, planning and coordinating integrated delivery of care across the continuum. Participates with senior leadership to establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care. This role will support operational needs 5am - 7pm PST. Working hours may vary and coverage will include Mon. - Sat. and some Holidays. Essential Job Duties - Directs and oversees one or more of the following key health care services functions: care management, utilization management, care transitions, long-term supports and services (LTSS), behavioral health, nurse advice line, and/or other special programs. - Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care coordination/care review and management. - Develops and promotes interdepartmental integration and collaboration to enhance clinical services. - Collaborates with and keeps healthcare services senior leadership informed of operational issues, staffing, resources, system and program needs and presents solutions/action plans for issues. - Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote a standardized enterprise-wide approach to healthcare services programs. - Ensures monthly auditing is occurring with appropriate follow-up. - Engages in clinical training activities and outcomes. - Develops and mentors direct reporting healthcare services leadership. - Local travel may be required (based upon state/contractual requirements). Required Qualifications -At least 8 years health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience. - At least 3 years health care management/leadership required. - Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. - Experience working within applicable state, federal, and third party regulations. - Ability to manage conflict and lead through change. - Operational and process improvement experience. - Ability to work cross-collaboratively across a highly matrixed organization. - Ability to prioritize and manage multiple deadlines. - Excellent organizational, problem-solving and critical-thinking skills. - Strong written and verbal communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Registered Nurse (RN). License must be active and unrestricted in state of practice. - Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification. - Medicaid/Medicare population experience. - Clinical experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $88,453 - $206,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions: utilization management, care management, behavioral health and other programs. Leads team responsible for assessing, facilitating, planning and coordinating integrated delivery of care across the continuum. Participates with senior leadership to establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care. This role will support operational needs 5am - 7pm PST. Working hours may vary and coverage will include Mon. - Sat. and some Holidays. Essential Job Duties - Directs and oversees one or more of the following key health care services functions: care management, utilization management, care transitions, long-term supports and services (LTSS), behavioral health, nurse advice line, and/or other special programs. - Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care coordination/care review and management. - Develops and promotes interdepartmental integration and collaboration to enhance clinical services. - Collaborates with and keeps healthcare services senior leadership informed of operational issues, staffing, resources, system and program needs and presents solutions/action plans for issues. - Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote a standardized enterprise-wide approach to healthcare services programs. - Ensures monthly auditing is occurring with appropriate follow-up. - Engages in clinical training activities and outcomes. - Develops and mentors direct reporting healthcare services leadership. - Local travel may be required (based upon state/contractual requirements). Required Qualifications -At least 8 years health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience. - At least 3 years health care management/leadership required. - Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. - Experience working within applicable state, federal, and third party regulations. - Ability to manage conflict and lead through change. - Operational and process improvement experience. - Ability to work cross-collaboratively across a highly matrixed organization. - Ability to prioritize and manage multiple deadlines. - Excellent organizational, problem-solving and critical-thinking skills. - Strong written and verbal communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Registered Nurse (RN). License must be active and unrestricted in state of practice. - Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification. - Medicaid/Medicare population experience. - Clinical experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $88,453 - $206,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions: utilization management, care management, behavioral health and other programs. Leads team responsible for assessing, facilitating, planning and coordinating integrated delivery of care across the continuum. Participates with senior leadership to establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care. This role will support operational needs 5am - 7pm PST. Working hours may vary and coverage will include Mon. - Sat. and some Holidays. Essential Job Duties • Directs and oversees one or more of the following key health care services functions: care management, utilization management, care transitions, long-term supports and services (LTSS), behavioral health, nurse advice line, and/or other special programs. • Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care coordination/care review and management. • Develops and promotes interdepartmental integration and collaboration to enhance clinical services. • Collaborates with and keeps healthcare services senior leadership informed of operational issues, staffing, resources, system and program needs and presents solutions/action plans for issues. • Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote a standardized enterprise-wide approach to healthcare services programs. • Ensures monthly auditing is occurring with appropriate follow-up. • Engages in clinical training activities and outcomes. • Develops and mentors direct reporting healthcare services leadership. • Local travel may be required (based upon state/contractual requirements). Required Qualifications •At least 8 years health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience. • At least 3 years health care management/leadership required. • Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. • Experience working within applicable state, federal, and third party regulations. • Ability to manage conflict and lead through change. • Operational and process improvement experience. • Ability to work cross-collaboratively across a highly matrixed organization. • Ability to prioritize and manage multiple deadlines. • Excellent organizational, problem-solving and critical-thinking skills. • Strong written and verbal communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification. • Medicaid/Medicare population experience. • Clinical experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions: utilization management, care management, behavioral health and other programs. Leads team responsible for assessing, facilitating, planning and coordinating integrated delivery of care across the continuum. Participates with senior leadership to establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care. This role will support operational needs 5am - 7pm PST. Working hours may vary and coverage will include Mon. - Sat. and some Holidays. Essential Job Duties - Directs and oversees one or more of the following key health care services functions: care management, utilization management, care transitions, long-term supports and services (LTSS), behavioral health, nurse advice line, and/or other special programs. - Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care coordination/care review and management. - Develops and promotes interdepartmental integration and collaboration to enhance clinical services. - Collaborates with and keeps healthcare services senior leadership informed of operational issues, staffing, resources, system and program needs and presents solutions/action plans for issues. - Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote a standardized enterprise-wide approach to healthcare services programs. - Ensures monthly auditing is occurring with appropriate follow-up. - Engages in clinical training activities and outcomes. - Develops and mentors direct reporting healthcare services leadership. - Local travel may be required (based upon state/contractual requirements). Required Qualifications -At least 8 years health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience. - At least 3 years health care management/leadership required. - Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. - Experience working within applicable state, federal, and third party regulations. - Ability to manage conflict and lead through change. - Operational and process improvement experience. - Ability to work cross-collaboratively across a highly matrixed organization. - Ability to prioritize and manage multiple deadlines. - Excellent organizational, problem-solving and critical-thinking skills. - Strong written and verbal communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Registered Nurse (RN). License must be active and unrestricted in state of practice. - Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification. - Medicaid/Medicare population experience. - Clinical experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $88,453 - $206,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs. * Facilitates behavioral health-related regional medical necessity reviews and cross coverage. * Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses. * Responds to behavioral health-related requests for proposal (RFP) sections and reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric diagnoses and treatment. * Provides second level behavioral health clinical reviews, peer reviews and appeals. * Supports behavioral health committees for quality compliance. * Implements behavioral health specific clinical practice guidelines and medical necessity review criteria. * Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the recruitment and orientation of new psychiatric medical directors. * Ensures all behavioral health programs and policies are in line with industry standards and best practices. * Assists with new program implementation and supports for health plan in-source behavioral health services. Required Qualifications * At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry/behavioral health, or equivalent combination of relevant education and experience. * Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state (NY) of practice. * Board Certification in Psychiatry. * Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff. * Ability to work cross-collaboratively within a highly matrixed organization. * Strong organizational and time-management skills. * Ability to multi-task and meet deadlines. * Attention to detail. * Critical-thinking and active listening skills. * Decision-making and problem-solving skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $186,201.39 - $363,093 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions: utilization management, care management, behavioral health and other programs. Leads team responsible for assessing, facilitating, planning and coordinating integrated delivery of care across the continuum. Participates with senior leadership to establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care. This role will support operational needs 5am - 7pm PST. Working hours may vary and coverage will include Mon. - Sat. and some Holidays. Essential Job Duties - Directs and oversees one or more of the following key health care services functions: care management, utilization management, care transitions, long-term supports and services (LTSS), behavioral health, nurse advice line, and/or other special programs. - Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care coordination/care review and management. - Develops and promotes interdepartmental integration and collaboration to enhance clinical services. - Collaborates with and keeps healthcare services senior leadership informed of operational issues, staffing, resources, system and program needs and presents solutions/action plans for issues. - Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote a standardized enterprise-wide approach to healthcare services programs. - Ensures monthly auditing is occurring with appropriate follow-up. - Engages in clinical training activities and outcomes. - Develops and mentors direct reporting healthcare services leadership. - Local travel may be required (based upon state/contractual requirements). Required Qualifications -At least 8 years health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience. - At least 3 years health care management/leadership required. - Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. - Experience working within applicable state, federal, and third party regulations. - Ability to manage conflict and lead through change. - Operational and process improvement experience. - Ability to work cross-collaboratively across a highly matrixed organization. - Ability to prioritize and manage multiple deadlines. - Excellent organizational, problem-solving and critical-thinking skills. - Strong written and verbal communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Registered Nurse (RN). License must be active and unrestricted in state of practice. - Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification. - Medicaid/Medicare population experience. - Clinical experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $88,453 - $206,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions: utilization management, care management, behavioral health and other programs. Leads team responsible for assessing, facilitating, planning and coordinating integrated delivery of care across the continuum. Participates with senior leadership to establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care. This role will support operational needs 5am - 7pm PST. Working hours may vary and coverage will include Mon. - Sat. and some Holidays. Essential Job Duties - Directs and oversees one or more of the following key health care services functions: care management, utilization management, care transitions, long-term supports and services (LTSS), behavioral health, nurse advice line, and/or other special programs. - Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care coordination/care review and management. - Develops and promotes interdepartmental integration and collaboration to enhance clinical services. - Collaborates with and keeps healthcare services senior leadership informed of operational issues, staffing, resources, system and program needs and presents solutions/action plans for issues. - Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote a standardized enterprise-wide approach to healthcare services programs. - Ensures monthly auditing is occurring with appropriate follow-up. - Engages in clinical training activities and outcomes. - Develops and mentors direct reporting healthcare services leadership. - Local travel may be required (based upon state/contractual requirements). Required Qualifications -At least 8 years health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience. - At least 3 years health care management/leadership required. - Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. - Experience working within applicable state, federal, and third party regulations. - Ability to manage conflict and lead through change. - Operational and process improvement experience. - Ability to work cross-collaboratively across a highly matrixed organization. - Ability to prioritize and manage multiple deadlines. - Excellent organizational, problem-solving and critical-thinking skills. - Strong written and verbal communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Registered Nurse (RN). License must be active and unrestricted in state of practice. - Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification. - Medicaid/Medicare population experience. - Clinical experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $88,453 - $206,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.