Lead, HCS (Non-Clinical) - Medicare - Military veterans preferred

JOB DESCRIPTION

Lead for Healthcare Services will be supporting a team of Care Review Processor supporting our Medicare line of business. This role will require working as Subject Matter Expert as well as training staff.

This is a remote role, home office with internet connectivity of high speed required.

Monday – Friday 8 AM to 5 PM (Resident Time Zone) – ability to cover Saturday/Sundays every 6 weeks) 

Job Summary

Molina Healthcare Services (HCS) Department works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS Central Programs staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. The Lead, HCS (Non-Clinical) functions as team lead in the health plan HCS Department. Responsibilities include oversight capabilities of daily administrative functions including staffing schedules, productivity, and work quality.

KNOWLEDGE/SKILLS/ABILITIES

• Assists in training of all staff according to Department standards, policies, and procedures. Evaluates the work performance of the health plan HCS Department staff. Consults with the Management of HCS to devise and implement corrective action as necessary to improve staff performance.
• Acts as a supportive resource to the HCS Department staff, assist in devising/implementing strategies of assignment delegation, facilitating HCS Department processes and communicating/coordinating activities.
• Resolves problems and complaints that may arise in day-to-day operations that involve HCS Department staff. Communicates findings to the Supervisor or Manager, HCS Department for resolution.
• Maintains a minimal caseload (as determined by leadership) and ensures communication and adherence to appropriate guidelines and support staff with daily operational and administrative compliance activities.
• Collaborates with and keeps HCS Management apprised of operational issues, staffing issues, system, and program needs.
• Monitors the HCS Department staff workload for adherence to the Department Policies, Procedures, Guidelines, and deadlines. Assures oversight and direction of individuals primarily responsible and assures timely completion.
• Actively participates in the Dept auditing program to review and communicate findings with staff and identify opportunities for improved quality and compliance.
• Acts as liaison to both internal and external customers on behalf of both Molina and HCS Department areas.
• Conducts self in a professional manner at all times. Maintains confidentiality, cooperative and effective workplace relationships and adheres to company Code of Conduct.
• Attends/participates in departmental, company-wide, and external committees, task forces, or work groups, as assigned.
• As an opportunity to encourage staff, share monthly quality and productivity scores with individual staff for awareness.

JOB QUALIFICATIONS

Required Education

High School Diploma or equivalent GED

Required Experience

• 3+ years’ experience in an administrative support role in healthcare, Medical Assistant
• Strong communication skills
• Strong analytic and problem-solving abilities

Preferred Education

Associate's or bachelor’s degree

Preferred Experience

3+ years’ experience in an administrative support role in healthcare, Medical Assistant preferred.

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: $16.23 - $35.17 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.