Green Bay, WI · Remote
$88.45K - $168.98K/yr
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 ...
Green Bay, WI · Remote
$88.45K - $168.98K/yr
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 ...
Appleton, WI · Remote
$91.10K - $121.80K/yr
Remote EDCi provides infrastructure and call center technology services and solutions to clients ... of risk mitigation standards and measures * Preferred background in healthcare, legal, technology ...
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Appleton, WI · Remote
$91.10K - $121.80K/yr
Remote EDCi provides infrastructure and call center technology services and solutions to clients ... of risk mitigation standards and measures * Preferred background in healthcare, legal, technology ...
Appleton, WI · On-site +1
$86.80K - $116.10K/yr
Remote EDCi provides infrastructure and call center technology services and solutions to clients ... of risk mitigation standards and measures * Preferred background in healthcare, legal, technology ...
Appleton, WI · On-site +1
$86.80K - $116.10K/yr
Remote EDCi provides infrastructure and call center technology services and solutions to clients ... of risk mitigation standards and measures * Preferred background in healthcare, legal, technology ...
Appleton, WI · Remote
$788/wk
... healthcare financing, enterprise risk management and regulatory compliance, data analytics and ... Location This role is ideally based in Seattle, Washington, but remote work within the United ...
Appleton, WI · Remote
$788/wk
... healthcare financing, enterprise risk management and regulatory compliance, data analytics and ... Location This role is ideally based in Seattle, Washington, but remote work within the United ...
Appleton, WI · On-site +1
... risk management and conflict resolution. This position is eligible to be fully remote and will ... food, and beverage, hospitality, healthcare, distribution facilities, and commercial and ...
Appleton, WI · On-site +1
... risk management and conflict resolution. This position is eligible to be fully remote and will ... food, and beverage, hospitality, healthcare, distribution facilities, and commercial and ...
Green Bay, WI · On-site +1
$142K/yr
Conduct risk assessments and implement risk management plans * Liaise with stakeholders to make ... Why Emplify Health by Bellin: With so many amazing healthcare organizations in this area, why ...
Green Bay, WI · On-site +1
$142K/yr
Conduct risk assessments and implement risk management plans * Liaise with stakeholders to make ... Why Emplify Health by Bellin: With so many amazing healthcare organizations in this area, why ...
Neenah, WI · On-site +1
$129.50K - $194.30K/yr
Driven by a passion for excellence, we partner with leading Aerospace/Defense, Healthcare/Life ... Vendor Management: Partner with major automation vendors to ensure third-party systems and remote ...
Neenah, WI · On-site +1
$129.50K - $194.30K/yr
Driven by a passion for excellence, we partner with leading Aerospace/Defense, Healthcare/Life ... Vendor Management: Partner with major automation vendors to ensure third-party systems and remote ...
Green Bay, WI · Remote
$40 - $60/hr
... health and medical tasks that include solving challenging problems and synthesizing insights ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...
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Green Bay, WI · Remote
$40 - $60/hr
... health and medical tasks that include solving challenging problems and synthesizing insights ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...
Green Bay, WI · On-site +1
... and performance management. Experience with healthcare regulations, such as HIPPA, and ... This position is remote, but may require travel, therefore, could be exposed to weather and road ...
Green Bay, WI · On-site +1
... and performance management. Experience with healthcare regulations, such as HIPPA, and ... This position is remote, but may require travel, therefore, could be exposed to weather and road ...
Green Bay, WI · Remote
$52K - $68.60K/yr
... and performance management. Experience with healthcare regulations, such as HIPPA, and ... This position is remote, but may require travel, therefore, could be exposed to weather and road ...
Green Bay, WI · Remote
$52K - $68.60K/yr
... and performance management. Experience with healthcare regulations, such as HIPPA, and ... This position is remote, but may require travel, therefore, could be exposed to weather and road ...
Green Bay, WI · On-site +1
$130.06K/yr
... risk management, and crisis intervention, on-call emergency services as assigned. There are ... the care and treatment of the individuals, including medical providers, security, probation and ...
Green Bay, WI · On-site +1
$130.06K/yr
... risk management, and crisis intervention, on-call emergency services as assigned. There are ... the care and treatment of the individuals, including medical providers, security, probation and ...
Green Bay, WI · Remote
$40 - $60/hr
This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ... Give AI chatbots diverse and complex healthcare-related problems and evaluate their outputs
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Green Bay, WI · Remote
$40 - $60/hr
This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ... Give AI chatbots diverse and complex healthcare-related problems and evaluate their outputs
Menasha, WI · Remote
... case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The Care ...
Menasha, WI · Remote
... case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The Care ...
Green Bay, WI · Remote
$50K/yr
Risk Management: * Monitor dealership conditions and performance * Develop and maintain risk ... Ability to work independently and in a remote environment * Proficient in Excel, Word, PowerPoint ...
Green Bay, WI · Remote
$50K/yr
Risk Management: * Monitor dealership conditions and performance * Develop and maintain risk ... Ability to work independently and in a remote environment * Proficient in Excel, Word, PowerPoint ...
Green Bay, WI · Remote
$50K/yr
Risk Management: * Monitor dealership conditions and performance * Develop and maintain risk ... Ability to work independently and in a remote environment * Proficient in Excel, Word, PowerPoint ...
Green Bay, WI · Remote
$50K/yr
Risk Management: * Monitor dealership conditions and performance * Develop and maintain risk ... Ability to work independently and in a remote environment * Proficient in Excel, Word, PowerPoint ...
Appleton, WI · On-site +1
$85.10K - $161.58K/yr
MedInsight is a subsidiary of Milliman; a global, employee-owned consultancy providing actuarial consulting, retirement funding and healthcare financing, enterprise risk management and regulatory ...
Appleton, WI · On-site +1
$85.10K - $161.58K/yr
MedInsight is a subsidiary of Milliman; a global, employee-owned consultancy providing actuarial consulting, retirement funding and healthcare financing, enterprise risk management and regulatory ...
Menasha, WI · Remote
... case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The Care ...
Menasha, WI · Remote
... case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The Care ...
Menasha, WI · On-site +1
Case Management certification preferred * Four years of clinical health care experience as a RN ... required * Previous experience in case management, utilization management, insurance, or managed ...
Menasha, WI · On-site +1
Case Management certification preferred * Four years of clinical health care experience as a RN ... required * Previous experience in case management, utilization management, insurance, or managed ...
In collaboration with the Care Manager (CM), implement risk mitigation strategies to promote the member's health, safety and independence while respecting the member's rights. * Participate in on ...
In collaboration with the Care Manager (CM), implement risk mitigation strategies to promote the member's health, safety and independence while respecting the member's rights. * Participate in on ...
In collaboration with the Care Manager (CM), implement risk mitigation strategies to promote the member's health, safety and independence while respecting the member's rights. * Participate in on ...
In collaboration with the Care Manager (CM), implement risk mitigation strategies to promote the member's health, safety and independence while respecting the member's rights. * Participate in on ...
$50.3K - $60.8K
4% of jobs
$60.8K - $71.3K
6% of jobs
$71.3K - $81.8K
11% of jobs
$85.7K is the 25th percentile. Wages below this are outliers.
$81.8K - $92.3K
11% of jobs
The median wage is $100.7K / yr.
$92.3K - $102.8K
23% of jobs
$102.8K - $113.3K
13% of jobs
$120.2K is the 75th percentile. Wages above this are outliers.
$113.3K - $123.8K
12% of jobs
$123.8K - $134.3K
8% of jobs
$134.3K - $144.9K
6% of jobs
$144.9K - $155.4K
4% of jobs
$155.4K - $165.9K
2% of jobs
$50.3K
$108.8K
$165.9K
$88.45K - $168.98K/yr
Full-time
Posted 3 days ago
8.0
Based on 191 frontline employees who took The Breakroom Quiz
146th of 259 rated insurance
JOB DESCRIPTION
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.
Essential Job Duties
Directs and oversee 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 occurs 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 of 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 of 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 - $168,981 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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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.
Health care and social assistance
10,000+ Employees
Long Beach, CA, US
1980
