12 Healthcare Roles jobs in Kingston

**Job Description**
**The Position**
The Regional Director, Field Medical is an integral member of the Medical Affairs Leadership Team. The Regional Director provides leadership and management of the Dermatology Medical Science Liaison (MSL) team in support of and alignment with Medical Affairs and Organon corporate objectives. The Regional Director is responsible for hiring, leading, managing, developing, and coaching MSLs; and ensuring the successful execution of plan and tactics; and proactively and compliantly collaborating with Commercial and other internal stakeholders.
**Responsibilities**
+ Build, lead, manage, develop, and coach the Field Medical Dermatology (FMD) team.
+ Define territories and geographic locations of FMDs based on KOL mapping data and business needs and track qualitative and quantitative metrics to meet objectives.
+ Create, anticipate, update, and implement training plans and field-based training curriculum to ensure FMDs possess the highest levels of product and disease state expertise and scientific acumen.
+ Actively manage FMD performance assessments, provide and document on-going coaching, assist with creation and execution of development plans, and monitor performance against expectations.
+ Proactively and compliantly collaborate with Commercial and other internal stakeholders and direct FMDs appropriately within legal and compliance policies to implement medical strategies that support launch operating plan and corporate objectives to establish Organon as a leader in immuno-dermatology.
+ Collaborate on the development and implementation of the scientific communication plan, medical-to-medical materials, and conduct of research including facilitation of investigator-initiated trials as well as investigator selection, relationship management, and site performance for Organon sponsored research. Maintain scientific and technical expertise in dermatology.
**Required Education, Experience and Skills**
+ PharmD, PhD, MD or equivalent education.
+ Seven plus years pharmaceutical industry experience.
+ Three plus years direct management experience, preferably of Field Medical teams.
+ Dermatology or Immunology experience is preferred.
+ Ability to develop and maintain strong, collaborative, and long-term relationships with colleagues, healthcare providers, decision makers, and organizations. Excellent interpersonal skills in both one-on-one and group settings and dedicated team player.
+ Strong oral communication, written communication, presentation, and coaching skills.
What We Look For In Our People
+ Highly motivated self-starter with an entrepreneurial spirit and commitment to personal and career development.
+ Desire to work in a quickly changing and fast-paced growing business.
+ Unrelenting dedication to delivering results and a desire to shape the strategic goals of the business. Willing to roll up your sleeves to get the job done.
+ Ability to overcome ambiguity and challenge the status quo.
+ Manage multiple programs with competing and aggressive timelines - prioritize activities and work independently.
+ Excellent written and oral communication skills. Experienced presenter of key messages to broad audiences including Senior Stakeholders.
Secondary Language(s) Job Description
**Who We Are:**
Organon delivers ingenious health solutions that enable people to live their best lives. We are a $6.5 billion global healthcare company focused on making a world of difference for women, their families and the communities they care for. We have an important portfolio and are growing it by investing in the unmet needs of Women's Health, expanding access to leading biosimilars and touching lives with a diverse and trusted portfolio of health solutions. Our Vision is clear: A better and healthier every day for every woman.
**US and PR Residents Only**
For more information about personal rights under Equal Employment Opportunity, visit:
EEOC Poster
EEOC GINA Supplement
OFCCP EEO Supplement
OFCCP Pay Transparency Rule
Organon is an Equal Opportunity Employer. We are committed to fostering a culture of inclusion, innovation, and belonging for all employees and job applicants. We ensure all employment practices are conducted without regard to race, color, religion, sex, sexual orientation, age, gender identity or gender expression, national origin, disability, veteran status, or any other characteristic protected by state or federal law.
**Search Firm Representatives Please Read Carefully**
Organon LLC., does not accept unsolicited assistance from search firms for employment opportunities. All CVs / resumes submitted by search firms to any employee at our company without a valid written search agreement in place for this position will be deemed the sole property of our company. No fee will be paid in the event a candidate is hired by our company as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.
**Applicable to United States Positions Only:** Under various U.S. state laws, Organon is required to provide a reasonable estimate of the salary range for this job. Final salary determinations take a number of factors into account including, but not limited to, primary work location, relevant skills, education level, and/or prior work experience. The applicable salary range for this position in the U.S. is stated below. Benefits offered in the U.S. include a retirement savings plan, paid vacation and holiday time, paid caregiver/parental and medical leave, and health benefits including medical, prescription drug, dental, and vision coverage in accordance with the terms and conditions of the applicable plans.
**Annualized Salary Range (US)**
$68,000.00 - 285,800.00
**Annualized Salary Range (Global)**
**Annualized Salary Range (Canada)**
**Please Note: Pay ranges are specific to local market and therefore vary from country to country.**
**Employee Status:**
Regular
**Relocation:**
No relocation
**VISA Sponsorship:**
No
**Travel Requirements:** **Organon employees must be able to satisfy all applicable travel and credentialing requirements, including associated vaccination prerequisites.**
50%
**Flexible Work Arrangements:**
Remote Work
**Shift:**
Not Indicated
**Valid Driving License:**
Yes
**Hazardous Material(s):**
**Number of Openings:**
1
**Requisition ID:** R

Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the lives of millions of people? Grifols is a global healthcare company that since 1909 has been working to improve the health and well-being of people around the world. We are leaders in plasma-derived medicines and transfusion medicine and develop, produce and market innovative medicines, solutions and services in more than 110 countries and regions.
The primary responsibility of the MSL Field Director is the management, performance, and coaching of a team of MSL direct reports in the Immunology and Neurology therapeutic area (MSL primary call points include Immunology, Neurology, Hematology/Oncology). The Field Director ensures compliant execution of field medical plans, strategy, and activities within Medical Affairs, as aligned with goals and objectives.
This position is a remote full-time role in the US with estimated 50% travel.
_Primary responsibilities include but are not limited to:_
+ Ultimate responsibility for scientific knowledge of self/team and oversight of a team of MSLs throughout the entire US.
+ Maintains clinical knowledge of designated therapeutic area(s) and broad market knowledge.
+ Provides leadership and serves as primary point of contact for operational/executional requests and solutions for the therapeutic area(s).
+ Partners with the Medical Directors, National MSL Sr Director, and North America Medical Affairs Sr Director to develop field medical strategies and tactics
+ Responsible for the MSL team's execution of field medical strategy for the assigned therapeutic area(s)
+ Conducts and/or assists MSLs in conducting formal presentations to appropriate groups such as the following: key accounts, managed care organizations, integrated systems, national medical associations, and medical schools. Acts as an "ambassador" representing Grifols' position and interests.
+ Participates and contributes in cross-functional teams (e.g., sales, marketing, global medical affairs) regarding field-based activities, medical insights, competitor activity gathering, data analysis, and evaluation of new and innovative initiatives.
+ Involved in the hiring, training, performance coaching, and overseeing the work of a team of MSL direct reports. Maintains the highest level of proficiency in the MSL function
+ Works with other MSL Field Directors regarding standardization and consistency of MSL role. Identifies opportunities for cross-functional integration of MSL roles and activities at the field level.
+ Ensures team's work performance and deliverables meet or exceed goals and objectives.
+ Ensures compliance with all applicable regulatory, legal, and operational rules and procedures of their team.
_Skills/Qualifications/Education:_ (To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, education, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions)
+ Previous leadership experience managing a team of MSLs (e.g., MSL Field Director, Regional MSL Director, National MSL Director, or equivalent) and proven history of success required.
+ Strong science/clinical background with advanced degree in a scientific field of study (PharmD, MD, PhD, or advanced/Master's nursing degree)
+ Typically requires 4 or more years of pharmaceutical industry experience as a field-based medical science liaison.
+ Experience developing and executing Key Opinion Leader territory plans, medical plans, and other field medical strategies.
+ Multi-dimensional in abilities to work on simultaneous tasks and work cross-functionally at various levels of the organization.
+ Strong organizational and collaborative skills, good personal initiative, attention to detail, and time management skills.
+ Self-directed, intrinsically motivated, flexible in changes in the organization and able to excel with minimal direction in a dynamic environment.
+ Excellent ability to understand, interpret, and communicate complex scientific and medical information and data.
+ Ability to comfortably converse with key academic opinion leaders regarding highly technical information.
+ Ability to manage a demanding travel schedule and be flexible.
+ Depending on the area of assignment, directly related experience or a combination of directly related education and experience and/or competencies may be considered in place of the stated requirements. Example: If a job level requires a bachelor's degree plus 4 years of experience, an equivalency could include 8 years of experience, an associate's degree with 6 years of experience, or a master's degree with 2 years of experience.
Must possess a valid driver's license in the state in which the employee works and meet the Qualifying Driver Criteria of the Grifols Fleet Program which includes but is not limited to a 5 year Motor Vehicle Records (MVR) lookback of major driving violations.
Pay Scale: The estimated pay scale for the Field Director, Medical Science Liaisons , Immunology/Neurology role based in the United States (non-California), is $195,000.00 - $50,000.00 per year. Additionally, the position is eligible to participate in 30% of the company bonus pool. We offer a wide variety of benefits including, but not limited to: Medical, Dental, Vision, PTO, 9 paid Holidays per year, up to 5% 401(K) match and tuition reimbursement. Final compensation packages will ultimately depend on education, experience, skillset, knowledge, where the role is performed, internal equity and market data. We are committed to offering our employees opportunities for professional growth and career progression. Grifols is a global healthcare organization with employees in 30 countries focused on patient health and providing impactful results. Since our humble beginnings in 1909, Grifols has been a family company that prides itself on its family-like culture. Our company has more than tripled over the last 10 years, and you can grow with us!
For Washington State: Currently, the first year PTO accrual for this role is 160 hours per year. Then, after completion of 365 days of employment the PTO accrual for this role will increase to 180 hours per year.
For California: The estimated pay scale for the Field Director, Medical Science Liaisons , Immunology/Neurology role based in California, is 205,000.00- 250,000.00 per year.
Work is performed in an office environment with exposure to electrical office equipment. Frequently sits for 6-8 hours per day. Frequent hand movement of both hands with the ability to make fast, simple movements of the fingers, hands, and wrists. Occasionally walks. Occasionally bends and twists neck. Light to moderate lifting and carrying objects with a maximum lift of 25lbs. Frequently drives to site locations with occasional travel within the United States. Able to communicate complex information and ideas so others will understand; with the ability to listen to and understand information and ideas presented through spoken words and sentences. Works independently with little guidance or reliance on oral or written instructions and plans work schedules to meet goals. Frequently interacts with others, relates sensitive information to diverse groups. Must work with diverse groups to obtain consensus on issues. Ability to apply abstract principles to solve complex conceptual issues. #LI-CB1
Third Party Agency and Recruiter Notice:
Agencies that present a candidate to Grifols must have an active, nonexpired, Grifols Agency Master Services Agreement with the Grifols Talent Acquisition Department. Additionally, agencies may only submit candidates to positions that they have been engaged to work on by a Grifols Recruiter. All resumes must be sent to a Grifols Recruiter under these terms or they will be considered a Grifols candidate.
**Grifols provides equal employment opportunities to applicants and employees without regard to race; color; sex; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; status as a protected veteran or spouse/family member of a protected veteran; or disability. We will consider for employment all qualified applicants in a manner consistent with the requirements of all applicable laws.**
Learn more about Grifols ( ID:**
**Type:** Regular Full-Time
**Job Category:** Medical Affairs

Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the lives of millions of people? Grifols is a global healthcare company that since 1909 has been working to improve the health and well-being of people around the world. We are leaders in plasma-derived medicines and transfusion medicine and develop, produce and market innovative medicines, solutions and services in more than 110 countries and regions.
The primary responsibility of the MSL Field Director is the management, performance, and coaching of a team of MSL direct reports in the Immunology and Neurology therapeutic area (MSL primary call points include Immunology, Neurology, Hematology/Oncology). The Field Director ensures compliant execution of field medical plans, strategy, and activities within Medical Affairs, as aligned with goals and objectives.
This position is a remote full-time role in the US with estimated 50% travel.
_Primary responsibilities include but are not limited to:_
+ Ultimate responsibility for scientific knowledge of self/team and oversight of a team of MSLs throughout the entire US.
+ Maintains clinical knowledge of designated therapeutic area(s) and broad market knowledge.
+ Provides leadership and serves as primary point of contact for operational/executional requests and solutions for the therapeutic area(s).
+ Partners with the Medical Directors, National MSL Sr Director, and North America Medical Affairs Sr Director to develop field medical strategies and tactics
+ Responsible for the MSL team's execution of field medical strategy for the assigned therapeutic area(s)
+ Conducts and/or assists MSLs in conducting formal presentations to appropriate groups such as the following: key accounts, managed care organizations, integrated systems, national medical associations, and medical schools. Acts as an "ambassador" representing Grifols' position and interests.
+ Participates and contributes in cross-functional teams (e.g., sales, marketing, global medical affairs) regarding field-based activities, medical insights, competitor activity gathering, data analysis, and evaluation of new and innovative initiatives.
+ Involved in the hiring, training, performance coaching, and overseeing the work of a team of MSL direct reports. Maintains the highest level of proficiency in the MSL function
+ Works with other MSL Field Directors regarding standardization and consistency of MSL role. Identifies opportunities for cross-functional integration of MSL roles and activities at the field level.
+ Ensures team's work performance and deliverables meet or exceed goals and objectives.
+ Ensures compliance with all applicable regulatory, legal, and operational rules and procedures of their team.
_Skills/Qualifications/Education:_ (To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, education, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions)
+ Previous leadership experience managing a team of MSLs (e.g., MSL Field Director, Regional MSL Director, National MSL Director, or equivalent) and proven history of success required.
+ Strong science/clinical background with advanced degree in a scientific field of study (PharmD, MD, PhD, or advanced/Master's nursing degree)
+ Typically requires 4 or more years of pharmaceutical industry experience as a field-based medical science liaison.
+ Experience developing and executing Key Opinion Leader territory plans, medical plans, and other field medical strategies.
+ Multi-dimensional in abilities to work on simultaneous tasks and work cross-functionally at various levels of the organization.
+ Strong organizational and collaborative skills, good personal initiative, attention to detail, and time management skills.
+ Self-directed, intrinsically motivated, flexible in changes in the organization and able to excel with minimal direction in a dynamic environment.
+ Excellent ability to understand, interpret, and communicate complex scientific and medical information and data.
+ Ability to comfortably converse with key academic opinion leaders regarding highly technical information.
+ Ability to manage a demanding travel schedule and be flexible.
+ Depending on the area of assignment, directly related experience or a combination of directly related education and experience and/or competencies may be considered in place of the stated requirements. Example: If a job level requires a bachelor's degree plus 4 years of experience, an equivalency could include 8 years of experience, an associate's degree with 6 years of experience, or a master's degree with 2 years of experience.
Must possess a valid driver's license in the state in which the employee works and meet the Qualifying Driver Criteria of the Grifols Fleet Program which includes but is not limited to a 5 year Motor Vehicle Records (MVR) lookback of major driving violations.
Pay Scale: The estimated pay scale for the Field Director, Medical Science Liaisons , Immunology/Neurology role based in the United States (non-California), is $195,000.00 - $50,000.00 per year. Additionally, the position is eligible to participate in 30% of the company bonus pool. We offer a wide variety of benefits including, but not limited to: Medical, Dental, Vision, PTO, 9 paid Holidays per year, up to 5% 401(K) match and tuition reimbursement. Final compensation packages will ultimately depend on education, experience, skillset, knowledge, where the role is performed, internal equity and market data. We are committed to offering our employees opportunities for professional growth and career progression. Grifols is a global healthcare organization with employees in 30 countries focused on patient health and providing impactful results. Since our humble beginnings in 1909, Grifols has been a family company that prides itself on its family-like culture. Our company has more than tripled over the last 10 years, and you can grow with us!
For Washington State: Currently, the first year PTO accrual for this role is 160 hours per year. Then, after completion of 365 days of employment the PTO accrual for this role will increase to 180 hours per year.
For California: The estimated pay scale for the Field Director, Medical Science Liaisons , Immunology/Neurology role based in California, is 205,000.00- 250,000.00 per year.
Work is performed in an office environment with exposure to electrical office equipment. Frequently sits for 6-8 hours per day. Frequent hand movement of both hands with the ability to make fast, simple movements of the fingers, hands, and wrists. Occasionally walks. Occasionally bends and twists neck. Light to moderate lifting and carrying objects with a maximum lift of 25lbs. Frequently drives to site locations with occasional travel within the United States. Able to communicate complex information and ideas so others will understand; with the ability to listen to and understand information and ideas presented through spoken words and sentences. Works independently with little guidance or reliance on oral or written instructions and plans work schedules to meet goals. Frequently interacts with others, relates sensitive information to diverse groups. Must work with diverse groups to obtain consensus on issues. Ability to apply abstract principles to solve complex conceptual issues. #LI-CB1
Third Party Agency and Recruiter Notice:
Agencies that present a candidate to Grifols must have an active, nonexpired, Grifols Agency Master Services Agreement with the Grifols Talent Acquisition Department. Additionally, agencies may only submit candidates to positions that they have been engaged to work on by a Grifols Recruiter. All resumes must be sent to a Grifols Recruiter under these terms or they will be considered a Grifols candidate.
**Grifols provides equal employment opportunities to applicants and employees without regard to race; color; sex; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; status as a protected veteran or spouse/family member of a protected veteran; or disability. We will consider for employment all qualified applicants in a manner consistent with the requirements of all applicable laws.**
Learn more about Grifols ( ID:**
**Type:** Regular Full-Time
**Job Category:** Medical Affairs

JOB DESCRIPTION Job SummaryProvides support for non-clinical healthcare services auditing activities. Responsible for performing audits for non-clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
- Performs audits of non-clinical staff in utilization management, care management, member assessment, and/or other teams - monitoring for compliance with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), and state and federal guidelines and requirements.
- Reports outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
- Ensures auditing approaches follow a Molina standard in approach and tool use.
- Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA).
- Demonstrates professionalism in all communications.
- Adheres to departmental standards, policies, protocols.
- Maintains detailed records of auditing results.
- Assists healthcare services with developing training materials or job aids as needed to address findings in audit results.
- Meets minimum production standards related to non-clinical auditing.
- May conduct staff trainings as needed.
- Communicates with quality, and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct.
Required Qualifications
- At least 2 years health care experience, preferably in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.
- Strong analytical and problem-solving skills.
- Ability to work in a cross-functional, professional environment.
- Ability to work on a team and independently.
- Excellent verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
- Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) non-clinical review/auditing 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
Pay Range: $24 - $56.17 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION Job SummaryProvides support for non-clinical healthcare services auditing activities. Responsible for performing audits for non-clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
- Performs audits of non-clinical staff in utilization management, care management, member assessment, and/or other teams - monitoring for compliance with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), and state and federal guidelines and requirements.
- Reports outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
- Ensures auditing approaches follow a Molina standard in approach and tool use.
- Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA).
- Demonstrates professionalism in all communications.
- Adheres to departmental standards, policies, protocols.
- Maintains detailed records of auditing results.
- Assists healthcare services with developing training materials or job aids as needed to address findings in audit results.
- Meets minimum production standards related to non-clinical auditing.
- May conduct staff trainings as needed.
- Communicates with quality, and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct.
Required Qualifications
- At least 2 years health care experience, preferably in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.
- Strong analytical and problem-solving skills.
- Ability to work in a cross-functional, professional environment.
- Ability to work on a team and independently.
- Excellent verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
- Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) non-clinical review/auditing 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
Pay Range: $24 - $56.17 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION
Job Summary
Provides support for non-clinical healthcare services auditing activities. Responsible for performing audits for non-clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
- Performs audits of non-clinical staff in utilization management, care management, member assessment, and/or other teams - monitoring for compliance with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), and state and federal guidelines and requirements.
- Reports outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
- Ensures auditing approaches follow a Molina standard in approach and tool use.
- Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA).
- Demonstrates professionalism in all communications.
- Adheres to departmental standards, policies, protocols.
- Maintains detailed records of auditing results.
- Assists healthcare services with developing training materials or job aids as needed to address findings in audit results.
- Meets minimum production standards related to non-clinical auditing.
- May conduct staff trainings as needed.
- Communicates with quality, and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct.
Required Qualifications
- At least 2 years health care experience, preferably in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.
- Strong analytical and problem-solving skills.
- Ability to work in a cross-functional, professional environment.
- Ability to work on a team and independently.
- Excellent verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
- Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) non-clinical review/auditing 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
Pay Range: $24 - $56.17 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION
Job Summary
Provides support for non-clinical healthcare services auditing activities. Responsible for performing audits for non-clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
- Performs audits of non-clinical staff in utilization management, care management, member assessment, and/or other teams - monitoring for compliance with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), and state and federal guidelines and requirements.
- Reports outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
- Ensures auditing approaches follow a Molina standard in approach and tool use.
- Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA).
- Demonstrates professionalism in all communications.
- Adheres to departmental standards, policies, protocols.
- Maintains detailed records of auditing results.
- Assists healthcare services with developing training materials or job aids as needed to address findings in audit results.
- Meets minimum production standards related to non-clinical auditing.
- May conduct staff trainings as needed.
- Communicates with quality, and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct.
Required Qualifications
- At least 2 years health care experience, preferably in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.
- Strong analytical and problem-solving skills.
- Ability to work in a cross-functional, professional environment.
- Ability to work on a team and independently.
- Excellent verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
- Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) non-clinical review/auditing 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
Pay Range: $24 - $56.17 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**Job Summary**
Provides subject matter expertise and leadership to healthcare services function - providing support for project/program/process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, policies and contractual commitments. Contributes to overarching strategy to provide quality and cost-effective member care.
**Essential Job Duties**
+ Collaboratively plans and executes internal healthcare services projects and programs involving department or cross-functional teams of subject matter experts - delivering products from the design process to completion.
+ Provides ongoing communication related to program goals, evaluation and support to ensure compliance with standardized protocols and processes.
+ May engage and oversee the work of external vendors.
+ Focuses on process improvement, organizational change management, program management and other processes relative to business needs.
+ Serves as a subject matter expert and leads healthcare services programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
+ Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality initiatives within the department as appropriate. - Creates business requirements documents (BRDs), test plans, requirements traceability matrix (RTMs), user training materials and other related business documents.
**Required Qualifications**
+ At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience.
+ Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
+ Strong analytical and problem-solving skills.
+ Strong organizational and time-management skills.
+ Ability to work in a cross-functional, professional environment.
+ Experience working within applicable state, federal, and third-party regulations.
+ Strong verbal and written communication skills.
+ Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
**Preferred Qualifications**
+ Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification.
+ Leadership experience.
+ Medicaid/Medicare population experience.
+ Six sigma certification
+ Experience with Agile Methodology
+ Experience with Epic
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
Pay Range: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**Job Summary**
Provides subject matter expertise and leadership to healthcare services function - providing support for project/program/process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, policies and contractual commitments. Contributes to overarching strategy to provide quality and cost-effective member care.
**Essential Job Duties**
+ Collaboratively plans and executes internal healthcare services projects and programs involving department or cross-functional teams of subject matter experts - delivering products from the design process to completion.
+ Provides ongoing communication related to program goals, evaluation and support to ensure compliance with standardized protocols and processes.
+ May engage and oversee the work of external vendors.
+ Focuses on process improvement, organizational change management, program management and other processes relative to business needs.
+ Serves as a subject matter expert and leads healthcare services programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
+ Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality initiatives within the department as appropriate. - Creates business requirements documents (BRDs), test plans, requirements traceability matrix (RTMs), user training materials and other related business documents.
**Required Qualifications**
+ At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience.
+ Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
+ Strong analytical and problem-solving skills.
+ Strong organizational and time-management skills.
+ Ability to work in a cross-functional, professional environment.
+ Experience working within applicable state, federal, and third-party regulations.
+ Strong verbal and written communication skills.
+ Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
**Preferred Qualifications**
+ Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification.
+ Leadership experience.
+ Medicaid/Medicare population experience.
+ Six sigma certification
+ Experience with Agile Methodology
+ Experience with Epic
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
Pay Range: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.