护理主任，医疗保健服务（加州远程办公）
RN Director, Healthcare Services (Remote in California)
职位描述
工作地点：加利福尼亚州 - 支持远程办公，但理想的候选人需居住在加利福尼亚州内。
此职位需要加利福尼亚州注册护士执照（RN）。候选人必须具备丰富的IPA授权经验。
领导并指导多学科医疗保健专业人员团队，负责以下部分或全部职能：利用管理、护理管理、行为健康及其他项目。领导负责评估、促进、规划和协调整个护理连续性中的整合护理的团队。与高级管理层合作制定战略计划和目标。为提供高质量且成本效益的会员护理做出总体战略贡献。
主要职责
· 指导和监督以下一个或多个关键医疗保健服务职能：护理管理、利用管理、护理过渡、长期支持和服务（LTSS）、行为健康、护士咨询热线和其他特殊项目。
• 制定、实施和/或监控临床和非临床团队活动的标准协议，以促进整合性的主动护理协调/护理审查和管理。
• 促进部门间整合与协作，以提升临床服务。
• 与医疗保健服务高级管理层合作，及时了解运营问题、人员配置、资源、系统和项目需求，并提出解决方案或行动计划。
• 根据需要参与委员会、工作组、任务组和多学科团队，以推动全企业范围内的医疗保健服务项目的标准化方法。
• 确保每月进行审计并进行适当的后续跟进。
• 参与临床培训活动和结果分析。
• 培养直接下属的医疗保健服务领导。
• 可能需要本地出差（根据州或合同要求）。
所需资格
- 至少8年医疗保健经验，其中至少5年在以下一个或多个领域有管理护理经验：利用管理、护理管理、护理过渡、行为健康、长期服务和支持（LTSS），或相关教育和经验的等效组合。
- 至少3年医疗保健管理/领导经验。
- 注册护士（RN）、执业护士（LVN）、助理护士（LPN）、临床社会工作者（LCSW）或其他相关认证。
查看英文原文
JOB DESCRIPTION Job Summary
Work Location: California - Ability to work remote, but ideal candidate will reside in the state of California.
This position requires California RN Licensure. Candidates must have significant IPA delegation experience.
Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions: utilization management, care management, behavioral health and other programs. Leads team responsible for assessing, facilitating, planning and coordinating integrated delivery of care across the continuum. Participates with senior leadership to establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
· Directs and oversees one or more of the following key health care services functions: care management, utilization management, care transitions, long-term supports and services (LTSS), behavioral health, nurse advice line, and/or other special programs.
• Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to facilitate integrated proactive care coordination/care review and management.
• Develops and promotes interdepartmental integration and collaboration to enhance clinical services.
• Collaborates with and keeps healthcare services senior leadership informed of operational issues, staffing, resources, system and program needs and presents solutions/action plans for issues.
• Facilitates and participates in committees, task forces, work groups and multidisciplinary teams as needed to promote a standardized enterprise-wide approach to healthcare services programs.
• Ensures monthly auditing is occurring with appropriate follow-up.
• Engages in clinical training activities and outcomes.
• Develops and mentors direct reporting healthcare services leadership.
• Local travel may be required (based upon state/contractual requirements).
Required Qualifications
- At least 8 years health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
- At least 3 years health care management/leadership required.
- Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). 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.
- Experience working within applicable state, federal, and third party regulations.
- Ability to manage conflict and lead through change.
- Operational and process improvement experience.
- Ability to work cross-collaboratively across a highly matrixed organization.
- Ability to prioritize and manage multiple deadlines.
- Excellent organizational, problem-solving and critical-thinking skills.
- Strong written and verbal communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
- Registered Nurse (RN). License must be active and unrestricted in state of practice.
- • Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification.
- • Medicaid/Medicare population experience.
• Clinical 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
Originally posted on Himalayas