Sr Case Management Processor

Job Summary

Responsible for working with members and providers to assess, facilitate, plan and coordinate the delivery of care across the continuum for members with potential risk for high cost and high utilization.

Responsible for leading project initiatives aimed at reducing the cost of care and improving quality. Oversees the development and implementation of new programs, processes, and practices in response to medical, operational, service, and regulatory initiatives. Identifies utilization management information needs and technologies. Develops and manages the annual operating budget within financial objectives.

• Provides support to the department staff by performing non‑clinical activities.
• Initial review and triage of Case Management tasks.
• Reviews data to identify principal member needs and works under the direction of the Case Manager to implement a care plan.
• Coordinates required services in accordance with member benefit plans.
• Promotes communication, both internally and externally, to enhance effectiveness of case management services.

• Required
  
  Education:
  
  Associate's Degree or equivalent combination of education and experience.
• Required Experience:
  
  1‑3 years.
• Preferred Education:
  
  Bachelor's Degree or equivalent combination of education and experience.
• Preferred Experience:
  
  3‑5 years.

Molina Healthcare offers a competitive benefits and compensation package.

Pay Range: $14.76 - $31.97 / HOURLY. Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.