KNOWLEDGE/SKILLS/ABILITIES

Provides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with state and federal regulations and guidelines. 

Responsible for the development and implementation of training curriculum for Utilization Management, Case Management, and LTSS staff.

• Responsible for evaluation of training effectiveness to ensure staff understanding and readiness.
• Educates staff on Molina standard programs and systems
  • Works with Health Plan leaders to ensure state specific regulations are included in training materials
  • Educates licensed staff regarding proper clinical judgment and approaches to proper decision making
  • Trains inter-disciplinary teams to collaborate in order to improve member quality of life and to control costs
  • Assists Care Review Clinicians with methods to present cases at multidisciplinary rounds
  • Ensures healthcare services staff understand professional standards of documentation
• Implements new employee orientation for health care service staff
  • Provides training for current staff for new programs or key initiatives
  • Provides training for system implementations and upgrades
  • Reeducates staff when deficiencies in performance are identified.
• Ensures staff attendance is recorded for trainings for record keeping and compliance.
• Acts as an information and problem-solving resource for healthcare services staff.
• 30% travel required.

JOB QUALIFICATIONS

Required Education

Completion of an accredited Registered Nurse (RN) Program and an Associate's or bachelor’s degree in Nursing,

Required Experience

• 3 or more years in case, disease, or utilization management; managed care; or medical/behavioral health settings.
• Experience demonstrating knowledge of adult educational/ learning theory and practice.
• Experience working independently and handling multiple projects simultaneously.
• Experience demonstrating knowledge of applicable state, and federal regulations/requirements.
• Proficient in MS/Word, Excel, PowerPoint.

Required License, Certification, Association

• Active, unrestricted State Registered Nursing (RN) License
• Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

Preferred Education

Bachelor's Degree in Nursing

Preferred Experience

• 5 or more years in case, disease, or utilization management; managed care; or medical/behavioral health settings.
• One year of training delivery and/or development experience.

Preferred License, Certification, Association

Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in Health Care Quality, or other related certification.

#PJHPO

#LI-AC1

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: $54,373.27 - $117,808.76 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.