Job Description
Job Summary
Provides support for member intake and care portal activities. Responsible for
member intake and care coordination portal operations/utilization. Supports the
care-centered home and fully integrated/accountable system of care, and
contributes to overarching strategy to improve and provide quality and
cost-effective member care.
Essential Job Duties
• Provides daily monitoring and management of the intake support center/care
coordination portal.
• Ensures that internal/external key stakeholders and members have access to
pertinent care coordination portal information.
• Ensures that member inquiries and concerns are addressed timely with
appropriate triage to assigned department(s).
• Represents as point of contact to external care coordination entities (CCEs),
care management entities (CMEs) and individual members and other key providers
and stakeholders as needed.
• Facilitates member referrals as needed.
• Attends training specific to care coordination portal use and access.
• Assists with monitoring required reporting requirements to ensure that members
needs are addressed timely and appropriately.
• Supports the care-centered home and fully integrated/accountable system of
care through population health management, and related processes, programs and
services.
• Assists in planning, organization, and design/development of program
components by coordinating work efforts across internal or external partners and
stakeholders to execute against program requirements.
• Monitors program/project metrics and ongoing process improvements.
• Builds partnerships and relationships with community-based organizations and
providers.
• Identifies and reports operational issues and needs to appropriate leadership.
• May conduct training, project scheduling, and reporting as required.
• Local travel may be required (based upon state/contractual requirements).
REQUIRED QUALIFICATIONS:
• At least 2 years of experience in care management, utilization management,
behavioral health, and/or a managed care setting, or equivalent combination of
relevant education and experience.
• Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN)). 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.
• Customer service and interpersonal skills.
• Attention to detail and organizational skills.
• Home office with high-speed internet connectivity.
• Effective verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
PREFERRED QUALIFICATIONS:
• Project or program coordination experience.
• Quality improvement 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.