JOB DESCRIPTIONJob SummaryMolina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical dependency services and assists with implementing integrated Behavioral Health care management programs.This position will support our Behavioral Health business overseeing projects. We are looking for a Clinical Programs Manager with a LMSW or LCSW, LCPC/LPC or RN-Psych licensure. Broad knowledge of Utilization Management, Case Management and understanding clinical operations is highly preferred. The candidate must have a background in Behavioral Health and experience with program development. This includes clinical Behavioral Health program development, outcome analysis, project management, and auditing experience. Further details provided during the interview.Work hours: Monday - Friday 8:00am- 5:00PM EST.This is a remote position with some business field travel.KNOWLEDGE/SKILLS/ABILITIES
Assists senior management as requested to review, evaluate, and potentially develop/implement new business opportunities, service expansion or other special projects specific to Behavioral Health (BH). Serves as project manager when requested for any such ventures.
Communicates state and federal regulatory changes related to BH benefits to Plan senior leadership.
Maintains accountability to Molina corporate BH leadership to ensure alignment with the Corporate standardized vision for integrated behavioral health enterprise wide.
Assists Compliance and Government Contracting with interpretation and adherence to all BH regulatory and contractual obligations, including but not limited to BH HEDIS measures, NCQA requirements, provider/member satisfaction and any other BH quality improvement or state audit activities.
Responsible for oversight and decision-making related to the administration of Behavioral Health (BH) benefits for Molina Healthcare members.
Works in collaboration with Care Review and Care Management leaders and staff in coordinating the clinical supervisory role for utilization and case management of BH cases as part of the broader integrated medical and BH care coordination team.
Participates in health plan BH/medical rounds and case conferences.
Serves as the Corporate BH subject matter expert available to all health plans as necessary.
Serves as a Corporate BH liaison to health plan operations and community outreach activities as necessary.
Represents Corporate Behavioral Health with stakeholders and officials on BH related issues to the provision of behavioral health benefits.
JOB QUALIFICATIONSRequired EducationGraduate Degree or equivalent combination of education and experienceRequired Experience
Three to five years in clinical practice.
Experience demonstrating an understanding of all elements of the full continuum of care spectrum of BH services (e.g., inpatient and outpatient services, community support services, substance abuse treatment programming, etc.).
Familiarity of treatment modalities and programs across ages inclusive of child and adult specialty programming.
Required License, Certification, AssociationActive and unrestricted master’s or Doctoral level licensure as a clinical behavioral health professional (PhD, PsyD, LCPC/LPC, LMFT, LCSW).Preferred EducationGraduate Degree or equivalent combination of education and experiencePreferred Experience
Two years in managed behavioral healthcare setting with at least 2 years clinical management experience.
More than 5 yrs. In clinical practice.
Preferred License, Certification, AssociationActive and unrestricted Doctoral level licensure as a behavioral health professional.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: $65,791.66 - $142,548.59 / ANNUALActual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
