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Job Description

Job Summary

Responsible for working with members and providers to assess, facilitate, plan and coordinate the delivery of care across the continuum for members with potential risk for high cost and high utilization. Responsible for leading project initiatives aimed at reducing the cost of care and quality improvement. Oversees the development and implementation of new programs, processes, and practices in response to medical, operational, service, and regulatory initiatives. Identifies utilization management information needs and technologies. Develops and manages the annual operating budget within financial objectives.

Knowledge/Skills/Abilities

• Provides support to the department staff by performing non clinical activities.

• Responsible for initial review and triage of Case Management tasks.

• Reviews data to identify principle member needs and works under the direction of the Case Manager to implement care plan.

• Coordinates required services in accordance with member benefit plan.

• Promotes communication, both internally and externally to enhance effectiveness of case management services..

Job Qualifications

Required Education

Associate's Degree or equivalent combination of education and experience

Required Experience

1-3 years

Preferred Education

Bachelor's Degree or equivalent combination of education and experience

Preferred Experience

3-5 years

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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: $14.76 - $31.97 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.