Live opening · Posted 4 days ago
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Job Description
Job Summary
Provides support for member intake and care portal activities. Responsible for member intake and care coordination portal operations/utilization. Supports the care-centered home and fully integrated/accountable system of care, and contributes to overarching strategy to improve and provide quality and cost-effective member care.
Essential Job Duties
Provides daily monitoring and management of the intake support center/care coordination portal.
Ensures that internal/external key stakeholders and members have access to pertinent care coordination portal information.
Ensures that member inquiries and concerns are addressed timely with appropriate triage to assigned department(s).
Represents as point of contact to external care coordination entities (CCEs), care management entities (CMEs) and individual members and other key providers and stakeholders as needed.
Facilitates member referrals as needed.
Attends training specific to care coordination portal use and access.
Assists with monitoring required reporting requirements to ensure that members needs are addressed timely and appropriately.
Supports the care-centered home and fully integrated/accountable system of care through population health management, and related processes, programs and services.
Assists in planning, organization, and design/development of program components by coordinating work efforts across internal or external partners and stakeholders to execute against program requirements.
Monitors program/project metrics and ongoing process improvements.
Builds partnerships and relationships with community-based organizations and providers.
Identifies and reports operational issues and needs to appropriate leadership.
May conduct training, project scheduling, and reporting as required.
Local travel may be required (based upon state/contractual requirements).
Required Qualifications
At least 2 years of experience in care management, utilization management, behavioral health, and/or a managed care setting, or equivalent combination of relevant education and experience.
Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN)). 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.
Customer service and interpersonal skills.
Attention to detail and organizational skills.
Home office with high-speed internet connectivity.
Effective verbal and written communication skills.
Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
Project or program coordination experience.
Quality improvement 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: $18.04 - $35.17 / HOURLY
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Work arrangement
Yes
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