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Molina Healthcare RN Manager, Healthcare Services TRAINING (UM, Case Management, Growth) in United States

JOB TITLE: MANAGER, HEALTHCARE SERVICES TRAINING (RN)

For this role, we are seeking a Healthcare Services Manager to oversee our Clinical Training staff. Contribute strategic recommendations to upper management for growth improvements and systems expertise. Solid experience in Clinical Systems Technology and change management. Lead efforts in CLINICAL CARE ADVANCE and PEGA UM systems training for Case Management and Utilization Management staff. Hands-on knowledge with PEGA or Clinical Care Advance (CCA) development and testing. Develop content for systems improvements.

REGISTERED NURSE preferred.

Job Description

Job Summary

Manages all activities associated with the development, implementation, and evaluation of training for the enterprise. Ensures employee compliance with training endeavors. Takes leadership role in evaluating/implementing new training opportunities.

Knowledge/Skills/Abilities

  • Responsible for clinical training teams supporting one or more of the following activities: utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), case management, transition of care, health management, and/or member assessment.

  • Responsible for the development, implementation, maintenance, and tracking of the Company’s enterprise wide HCS training program, ensuring training compliance with state and federal regulatory and accrediting standards and implementation of the Molina Clinical Model.

  • Manages and evaluates team member performance; provides coaching, consultation, employee development, and recognition; ensures ongoing, appropriate staff training; holds regular team meetings to drive good communication and collaboration; and has responsibility for the selection, orientation, and mentoring of new staff.

  • Functions as a hands-on manager responsible for supervision, coordination of daily training activities, scheduling, management of training requests, and serves as a problem-solving and troubleshooting resource. Resolves and/or appropriately raises awareness on at-risk items in a timely fashion.

  • Ensures adequate staffing to support training, staff productivity and other performance indicators.

  • Maintains professional relationships with internal and external stakeholders and collaborates with cross-functional teams to ensure training content is relevant and meets the needs of our customers.

  • Manages program logistics and coordination of a comprehensive new employee orientation (NEO) program and continuous learning opportunities for health care service staff

  • Manages a diverse team of Clinical Services Trainers responsible for delivering NEO, implementations, clinical initiatives and special projects.

  • Collaborates in the development of training content, design, technology and implementation efforts, including identification of goals, objectives, critical success factors and success measures.

  • Ensures training team is knowledgeable of upcoming training initiatives, assigns resources needed and identifies individual responsibilities.

  • Ensures training team is well-informed of changes in process that impact curricula; coordinates necessary train the trainer opportunities; and confirms that updates have been incorporated into New Employee Orientation.

  • Responsible for evaluation of training effectiveness to ensure staff understanding and readiness.

  • Participates in committees and/or workgroups and evaluates and implements recommendations from the committees that are applicable to staff training.

  • Continuously seek and support new approaches, practices and processes to improve the

efficiency of training services offered.

Job Qualifications

REQUIRED EDUCATION:

  • Registered Nurse OR Bachelor's degree in Nursing, Public Health, Social Work, or related field.

REQUIRED EXPERIENCE:

  • 5+ years of managed healthcare experience, including 3 or more years in one or more of the following areas: utilization management, case management, care transition and/or disease management.

  • 3+ years in training and development capacity

  • Minimum 2 years of healthcare or health plan supervisory or managerial experience, including oversight of clinical staff.

  • Proven experience partnering with business leaders on training design and execution, instructional design, adult learning theory and deploying training through innovative solutions

  • Experience working within applicable state, federal, and third-party regulations.

  • Strong organizational and time management skills

  • Ability to multi-task and meet project deadlines

  • Attention to detail and self-proofing

  • Ability to work under minimal supervision and has a high level of personal initiative

  • Ability to build relationships

  • Strong problem-solving mindset with the ability to synthesize multiple opinions and feedback

  • Strong oral, written, listening and presentation skills

  • Able to demonstrate a high level of confidentiality

  • Resourceful and creative with problem solving

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

  • If licensed, license must be active, unrestricted and in good standing.

  • Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

PREFERRED EDUCATION:

  • Master's Degree in Nursing, Public Health, Social Work, or related field

PREFERRED EXPERIENCE:

  • 3+ years supervisory/management experience in a managed healthcare environment.

  • Medicaid/Medicare Population experience with increasing responsibility.

  • 3+ years of clinical nursing experience.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

Any of the following:

  • Certified Case Manager (CCM), Certified Professional in Healthcare Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification.

PHYSICAL DEMANDS:

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed remotely in a home office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function

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.

#PJCorp

#LI-AC1

Pay Range: $65,791.66 - $142,548.59 / ANNUAL

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

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