Director, Healthcare Services (RN) (Remote in Massachusetts)

JOB DESCRIPTION Job Summary<br/><br/>This position will offer remote work flexibility but the selected candidate will need to reside in Massachusetts or a neighboring state. <br/><br/>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.<br/><br/>Essential Job Duties<br/>• 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.<br/> • Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care coordination/care review and management.<br/> • Develops and promotes interdepartmental integration and collaboration to enhance clinical services.<br/> • 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.<br/> • 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.<br/> • Ensures monthly auditing is occurring with appropriate follow-up.<br/> • Engages in clinical training activities and outcomes.<br/> • Develops and mentors direct reporting healthcare services leadership.<br/> • Local travel may be required (based upon state/contractual requirements).<br/><br/>Required Qualifications<br/>• 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.<br/>• At least 3 years health care management/leadership required.<br/>• 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.<br/>• Experience working within applicable state, federal, and third party regulations.<br/>• Ability to manage conflict and lead through change.<br/>• Operational and process improvement experience.<br/>• Ability to work cross-collaboratively across a highly matrixed organization.<br/>• Ability to prioritize and manage multiple deadlines.<br/>• Excellent organizational, problem-solving and critical-thinking skills.<br/>• Strong written and verbal communication skills.<br/>• Microsoft Office suite/applicable software program(s) proficiency.<br/><br/>Preferred Qualifications<br/>• Registered Nurse (RN). License must be active and unrestricted in state of practice.<br/> • 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.<br/> • Medicaid/Medicare population experience.<br/> • Clinical experience.<br/><br/>To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.<br/><br/> Molina Healthcare offers a competitive benefits and compensation package.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

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Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...