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General Manager
Reno, NV
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Molina Healthcare

VP, Healthcare Services

Job Description

As VP, Healthcare Services, you will provide executive-level strategy and leadership to a multidisciplinary team of healthcare services professionals. Your role is crucial in ensuring members achieve desired outcomes through integrated care delivery and coordination across the continuum. You will partner with executive leadership to align with business goals and contribute to the overarching strategy for quality and cost-effective member care. Leading Healthcare Services Strategy Develop and implement executive health plan or enterprise strategy for healthcare services functions. Determine strategic clinical, quality, and financial measures for success. Facilitate integrated, proactive healthcare services management, ensuring compliance with regulatory standards. Oversee state plan implementation of a fully integrated service model for whole health needs. Facilitate integration of care coordination, transitions, long-term care, and behavioral health programs. Develop, implement, and monitor standardized protocols for clinical and non-clinical team activities. Ensure adequate staffing and service levels, maintaining customer satisfaction. Collaborate with the Chief Medical Officer to develop processes for managing clinical policies. Develop initiatives to achieve budgeted reductions in medical expenses and increases in quality scores. Oversee implementation of various healthcare services activities in accordance with regulatory and accreditation compliance. Ensure delivery of member care and services align with established standards of customer service excellence. Oversee ongoing monitoring of performance, protocols, and guidelines related to healthcare services. Keep senior leadership apprised of operational issues and present solutions. Promote interdepartmental/multidisciplinary integration and collaboration. Ensure completion of staff quality audit reviews and recommend enhancements. Continually refine operational processes and champion review of team workflows. Ensure compliance with all contractual obligations. Manage implementation of analytical studies to quantify benefits of healthcare services programs. Analyze and report on care access and monitoring statistics. Provide oversight in the successful implementation of healthcare services for new business/expansions. Identify and review new products to enhance care service delivery. Develop healthcare services department budget and ensure budget targets are met. Why Join Our Executive Team? Competitive compensation package Comprehensive benefits package Why Join Our Executive Team? Molina Healthcare offers a competitive compensation and benefits package, ensuring you are well-rewarded for your executive leadership in healthcare services. Who We Are Looking For We are seeking a highly experienced and dynamic leader for the VP, Healthcare Services role. The ideal candidate will possess at least 12 years of healthcare experience, with a significant portion in managed care across areas such as utilization management, care management, or behavioral health. You should have a proven track record of at least 7 years in management and leadership, demonstrating strong customer service skills and a member-centric approach. The ability to navigate complex regulatory environments, coupled with excellent data analysis, critical thinking, and problem-solving skills, is essential. We value candidates who can collaborate effectively across functions, manage conflict, and drive change within a matrixed organization. Clinical licensure, if applicable, must be active and unrestricted. At least 12 years of healthcare experience, with 10+ years in managed care (utilization management, care management, behavioral health, LTSS, or special programs). At least 7 years of management/leadership experience. Clinical licensure (RN, LVN, LPN, LCSW, LMFT, LPCC, or LMSW) if required by state contract or regulation, active and unrestricted. Experience working within applicable state, federal, and third-party regulations. Strong customer service skills with a member-centric focus. Ability to work in diverse settings and adjust style as needed. Data analysis and critical-thinking skills. Ability to prioritize and manage multiple deadlines. Strong organizational and problem-solving skills. Operational and process improvement experience. Ability to collaborate cross-functionally within a highly matrixed organization. Ability to manage conflict and lead through change. Excellent written and verbal communication skills. Proficiency in Microsoft Office suite and applicable software programs. Clinical experience (preferred). Registered Nurse (RN) or master's level behavioral health (BH) licensure (preferred). Certified Case Manager (CCM), Certified Professional in Health Care Management (CPHM), or Certified Professional in Health Care Quality (CPHQ) certification (preferred). Medicaid/Medicare population experience (preferred). What We Offer You Purpose-driven culture focused on helping underserved communities Collaborative and supportive team environment Opportunity to make a significant impact on member health and lives Local travel may be required based on state/contractual requirements Lead Healthcare Strategy and Impact Lives Lead the strategic direction of healthcare services as a VP, driving integrated care delivery and ensuring optimal outcomes for members. This executive role offers a competitive salary and the chance to make a profound impact within a purpose-driven organization.

Benefits

  • Dental Insurance
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