Job Description

JOB DESCRIPTION Job Summary

Provides executive level strategy and leadership to a multidisciplinary team of healthcare services professionals supporting members with long-term services and supports (LTSS) needs - ensuring members reach desired outcomes through integrated delivery and coordination of care across the continuum. Plans and coordinates best practices that deliver outcomes for members, with a focus on person-centered and strength-based activities of daily living support needs, community integration and stability goals for all populations and member progress towards independence. Analyzes clinical trends, operational/quality performance, and program evaluation that impact member outcomes and financial performance. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• Supports executive strategy development, vision and direction for long-term services and supports (LTSS) activities. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
• Provides LTSS expertise to develop and execute strategic, tactical, and operational goals, and implement and managed programs that enable older adults and individuals with disabilities to live independently in a setting of their choice while improving health outcomes and quality of life.
• Ensures the overall level of quality for delivery of LTSS services meets or exceeds appropriate standards.
• Partners with cross-functionally to develop short and long-term LTSS financial goals, operational plans, and appropriate metrics to strengthen LTSS performance.
• Collaborates with growth leaders and departments across the organization to achieve strategic and corporate business objectives for LTSS business growth.
• Analyzes clinical trends, operational/quality performance, and program evaluation that impacts member outcomes and financial performance of the product.
• Assesses, evaluates, and communicates LTSS’s overall performance, drivers of performance, opportunities, risks, and plans for ensuring program success/business objectives to a variety of audiences.
• Ensures that LTSS reporting systems and oversight processes monitor and accurately identify relevant performance issues on a daily, weekly, and monthly basis; this includes both financial and key operating reporting systems and metrics - ensuring systems and processes accurately predict performance issues and allow for timely course corrections.
• Collaborates with cross-functional leaders to ensure that plans are developed and implemented to address LTSS performance issues.
• Interprets state and national LTSS policy and regulatory guidance to understand business impact, and ensures programs are established to comply with all relevant federal, state, and local regulations.
• Hires, trains, develops and manages team demonstrates accountability for team performance and achievement of department-specific goals.
• Develops and sustains a high-performance team, dedicated to best-in-class solutions responsible for attracting, developing and retaining top-tier talent to support strategy and long-term business objectives.

Required Qualifications

• At least 12 years of experience in health care leading state long-term care services programs in a multi-faceted health plan, health care system, or similar service delivery organization, operational performance management, provider relationships, financial planning and budgeting, strategic planning, risk management, capital generation, revenue management (patient billing, revenue), controllership and internal audit, or equivalent combination of relevant education and experience.
• At least 7 years of management/leadership experience.
• Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board mandate.
• Experience in working across regulatory agencies in program development and implementation.
• Excellent organizational and time-management skills.
• Ability to work cross-collaboratively in a highly matrixed environment.
• Ability to lead change management and cross-enterprise initiatives.
• Flexibility in the work environment, willingness, and ability to adapt to changing organizational needs.
• Excellent verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

• Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), or other applicable clinical licensure.
• Experience working with in-home supportive services (IHSS), public authorities, and community-based organizations (CBOs).
• Experience leading a managed care line of business."

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.