12 Saint Alphonsus Health System jobs in Star
Healthcare Services Operations Support Auditor
83756 Boise, Idaho
Molina Healthcare
Posted today
Job Viewed
Job Description
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.
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.
View Now
0
Healthcare Services Operations Support Auditor
83605 Caldwell, Idaho
Molina Healthcare
Posted today
Job Viewed
Job Description
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.
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.
View Now
1
Healthcare Services Operations Support Auditor
83642 Meridian, Idaho
Molina Healthcare
Posted today
Job Viewed
Job Description
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.
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.
View Now
2
Healthcare Services Operations Support Auditor
83642 Meridian, Idaho
Molina Healthcare
Posted 1 day ago
Job Viewed
Job Description
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 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.
View Now
3
Healthcare Services Operations Support Auditor
83756 Boise, Idaho
Molina Healthcare
Posted 1 day ago
Job Viewed
Job Description
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 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.
View Now
4
Healthcare Services Operations Support Auditor
83605 Caldwell, Idaho
Molina Healthcare
Posted 1 day ago
Job Viewed
Job Description
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 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.
View Now
5
Director, Clinical Operations
83642 Meridian, Idaho
Molina Healthcare
Posted 1 day ago
Job Viewed
Job Description
**Job Description**
**Job Summary**
The Director, Clinical Operations is responsible for the clinical operations within the Clinical Contact Center team.
**Job Duties**
- Directs all Clinical Contact Center operations
- Implements direction and performance standards for multiple lines of business to assure that service targets are achieved.
- Manages and evaluates the performance of various clinical management activities.
- Aligns with Senior Leadership, to ensure operational goals and objectives for outsourced operations are understood and met.
- Ensures services provided to members are compliant with contractual expectations and specific regulatory requirements.
- Proficient in discussion and execution of procedures, protocols, benefits, and services, assists with training of new employees as needed, shows flexibility in meeting changing performance objectives consistent with department objectives.
- Develops standardized methods of improving production, quality, and efficiency
- Ensures partners receive support for operational issues.
- Produces solutions to a problem or issues Calculates risks f and takes decisive actions where necessary. Ensures that guidance or action is in keeping with policy and procedure.
- Schedules and reviews project tasks to ensure high quality product is delivered on time and within the budget.
- Engaged in clinical training activities and outcomes.
- Determines clinical and quality measures for success.
- Designs standardized protocols, develops policy, and ensures timely implementation with corporate and health plan input.
- Ensures monthly auditing is occurring with appropriate follow-up.
- Utilizes excellent verbal and written communication skills
- Utilizes advanced teambuilding and conflict resolution skills
- Performs other duties as required
**Job Qualifications**
**REQUIRED EDUCATION** :
Completion of an accredited Registered Nurse (RN) Program or Bachelor's Degree in Nursing
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- Minimum 7 years' experience in a healthcare environment with directly transferable skills highly preferred.
- Minimum 7 years' experience performing supervisory/management work including Clinical Operations.
- Experience with Contact Center operations.
- Experience managing professional staff in a clinical Contact Center.
- Experience managing process improvement activities.
**REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** :
Active, unrestricted State Registered Nursing (RN) license in good standing
**PREFERRED EXPERIENCE** :
+ 9 years' experience in a healthcare environment with directly transferable skills highly preferred
+ 9 years' experience performing supervisory/management work including Clinical Operations.
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: $97,299 - $227,679 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Summary**
The Director, Clinical Operations is responsible for the clinical operations within the Clinical Contact Center team.
**Job Duties**
- Directs all Clinical Contact Center operations
- Implements direction and performance standards for multiple lines of business to assure that service targets are achieved.
- Manages and evaluates the performance of various clinical management activities.
- Aligns with Senior Leadership, to ensure operational goals and objectives for outsourced operations are understood and met.
- Ensures services provided to members are compliant with contractual expectations and specific regulatory requirements.
- Proficient in discussion and execution of procedures, protocols, benefits, and services, assists with training of new employees as needed, shows flexibility in meeting changing performance objectives consistent with department objectives.
- Develops standardized methods of improving production, quality, and efficiency
- Ensures partners receive support for operational issues.
- Produces solutions to a problem or issues Calculates risks f and takes decisive actions where necessary. Ensures that guidance or action is in keeping with policy and procedure.
- Schedules and reviews project tasks to ensure high quality product is delivered on time and within the budget.
- Engaged in clinical training activities and outcomes.
- Determines clinical and quality measures for success.
- Designs standardized protocols, develops policy, and ensures timely implementation with corporate and health plan input.
- Ensures monthly auditing is occurring with appropriate follow-up.
- Utilizes excellent verbal and written communication skills
- Utilizes advanced teambuilding and conflict resolution skills
- Performs other duties as required
**Job Qualifications**
**REQUIRED EDUCATION** :
Completion of an accredited Registered Nurse (RN) Program or Bachelor's Degree in Nursing
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- Minimum 7 years' experience in a healthcare environment with directly transferable skills highly preferred.
- Minimum 7 years' experience performing supervisory/management work including Clinical Operations.
- Experience with Contact Center operations.
- Experience managing professional staff in a clinical Contact Center.
- Experience managing process improvement activities.
**REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** :
Active, unrestricted State Registered Nursing (RN) license in good standing
**PREFERRED EXPERIENCE** :
+ 9 years' experience in a healthcare environment with directly transferable skills highly preferred
+ 9 years' experience performing supervisory/management work including Clinical Operations.
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: $97,299 - $227,679 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now
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6
Director, Clinical Operations
83756 Boise, Idaho
Molina Healthcare
Posted 1 day ago
Job Viewed
Job Description
**Job Description**
**Job Summary**
The Director, Clinical Operations is responsible for the clinical operations within the Clinical Contact Center team.
**Job Duties**
- Directs all Clinical Contact Center operations
- Implements direction and performance standards for multiple lines of business to assure that service targets are achieved.
- Manages and evaluates the performance of various clinical management activities.
- Aligns with Senior Leadership, to ensure operational goals and objectives for outsourced operations are understood and met.
- Ensures services provided to members are compliant with contractual expectations and specific regulatory requirements.
- Proficient in discussion and execution of procedures, protocols, benefits, and services, assists with training of new employees as needed, shows flexibility in meeting changing performance objectives consistent with department objectives.
- Develops standardized methods of improving production, quality, and efficiency
- Ensures partners receive support for operational issues.
- Produces solutions to a problem or issues Calculates risks f and takes decisive actions where necessary. Ensures that guidance or action is in keeping with policy and procedure.
- Schedules and reviews project tasks to ensure high quality product is delivered on time and within the budget.
- Engaged in clinical training activities and outcomes.
- Determines clinical and quality measures for success.
- Designs standardized protocols, develops policy, and ensures timely implementation with corporate and health plan input.
- Ensures monthly auditing is occurring with appropriate follow-up.
- Utilizes excellent verbal and written communication skills
- Utilizes advanced teambuilding and conflict resolution skills
- Performs other duties as required
**Job Qualifications**
**REQUIRED EDUCATION** :
Completion of an accredited Registered Nurse (RN) Program or Bachelor's Degree in Nursing
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- Minimum 7 years' experience in a healthcare environment with directly transferable skills highly preferred.
- Minimum 7 years' experience performing supervisory/management work including Clinical Operations.
- Experience with Contact Center operations.
- Experience managing professional staff in a clinical Contact Center.
- Experience managing process improvement activities.
**REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** :
Active, unrestricted State Registered Nursing (RN) license in good standing
**PREFERRED EXPERIENCE** :
+ 9 years' experience in a healthcare environment with directly transferable skills highly preferred
+ 9 years' experience performing supervisory/management work including Clinical Operations.
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: $97,299 - $227,679 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Summary**
The Director, Clinical Operations is responsible for the clinical operations within the Clinical Contact Center team.
**Job Duties**
- Directs all Clinical Contact Center operations
- Implements direction and performance standards for multiple lines of business to assure that service targets are achieved.
- Manages and evaluates the performance of various clinical management activities.
- Aligns with Senior Leadership, to ensure operational goals and objectives for outsourced operations are understood and met.
- Ensures services provided to members are compliant with contractual expectations and specific regulatory requirements.
- Proficient in discussion and execution of procedures, protocols, benefits, and services, assists with training of new employees as needed, shows flexibility in meeting changing performance objectives consistent with department objectives.
- Develops standardized methods of improving production, quality, and efficiency
- Ensures partners receive support for operational issues.
- Produces solutions to a problem or issues Calculates risks f and takes decisive actions where necessary. Ensures that guidance or action is in keeping with policy and procedure.
- Schedules and reviews project tasks to ensure high quality product is delivered on time and within the budget.
- Engaged in clinical training activities and outcomes.
- Determines clinical and quality measures for success.
- Designs standardized protocols, develops policy, and ensures timely implementation with corporate and health plan input.
- Ensures monthly auditing is occurring with appropriate follow-up.
- Utilizes excellent verbal and written communication skills
- Utilizes advanced teambuilding and conflict resolution skills
- Performs other duties as required
**Job Qualifications**
**REQUIRED EDUCATION** :
Completion of an accredited Registered Nurse (RN) Program or Bachelor's Degree in Nursing
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- Minimum 7 years' experience in a healthcare environment with directly transferable skills highly preferred.
- Minimum 7 years' experience performing supervisory/management work including Clinical Operations.
- Experience with Contact Center operations.
- Experience managing professional staff in a clinical Contact Center.
- Experience managing process improvement activities.
**REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** :
Active, unrestricted State Registered Nursing (RN) license in good standing
**PREFERRED EXPERIENCE** :
+ 9 years' experience in a healthcare environment with directly transferable skills highly preferred
+ 9 years' experience performing supervisory/management work including Clinical Operations.
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: $97,299 - $227,679 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now
7
Director, Clinical Operations
83605 Caldwell, Idaho
Molina Healthcare
Posted 1 day ago
Job Viewed
Job Description
**Job Description**
**Job Summary**
The Director, Clinical Operations is responsible for the clinical operations within the Clinical Contact Center team.
**Job Duties**
- Directs all Clinical Contact Center operations
- Implements direction and performance standards for multiple lines of business to assure that service targets are achieved.
- Manages and evaluates the performance of various clinical management activities.
- Aligns with Senior Leadership, to ensure operational goals and objectives for outsourced operations are understood and met.
- Ensures services provided to members are compliant with contractual expectations and specific regulatory requirements.
- Proficient in discussion and execution of procedures, protocols, benefits, and services, assists with training of new employees as needed, shows flexibility in meeting changing performance objectives consistent with department objectives.
- Develops standardized methods of improving production, quality, and efficiency
- Ensures partners receive support for operational issues.
- Produces solutions to a problem or issues Calculates risks f and takes decisive actions where necessary. Ensures that guidance or action is in keeping with policy and procedure.
- Schedules and reviews project tasks to ensure high quality product is delivered on time and within the budget.
- Engaged in clinical training activities and outcomes.
- Determines clinical and quality measures for success.
- Designs standardized protocols, develops policy, and ensures timely implementation with corporate and health plan input.
- Ensures monthly auditing is occurring with appropriate follow-up.
- Utilizes excellent verbal and written communication skills
- Utilizes advanced teambuilding and conflict resolution skills
- Performs other duties as required
**Job Qualifications**
**REQUIRED EDUCATION** :
Completion of an accredited Registered Nurse (RN) Program or Bachelor's Degree in Nursing
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- Minimum 7 years' experience in a healthcare environment with directly transferable skills highly preferred.
- Minimum 7 years' experience performing supervisory/management work including Clinical Operations.
- Experience with Contact Center operations.
- Experience managing professional staff in a clinical Contact Center.
- Experience managing process improvement activities.
**REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** :
Active, unrestricted State Registered Nursing (RN) license in good standing
**PREFERRED EXPERIENCE** :
+ 9 years' experience in a healthcare environment with directly transferable skills highly preferred
+ 9 years' experience performing supervisory/management work including Clinical Operations.
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: $97,299 - $227,679 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Summary**
The Director, Clinical Operations is responsible for the clinical operations within the Clinical Contact Center team.
**Job Duties**
- Directs all Clinical Contact Center operations
- Implements direction and performance standards for multiple lines of business to assure that service targets are achieved.
- Manages and evaluates the performance of various clinical management activities.
- Aligns with Senior Leadership, to ensure operational goals and objectives for outsourced operations are understood and met.
- Ensures services provided to members are compliant with contractual expectations and specific regulatory requirements.
- Proficient in discussion and execution of procedures, protocols, benefits, and services, assists with training of new employees as needed, shows flexibility in meeting changing performance objectives consistent with department objectives.
- Develops standardized methods of improving production, quality, and efficiency
- Ensures partners receive support for operational issues.
- Produces solutions to a problem or issues Calculates risks f and takes decisive actions where necessary. Ensures that guidance or action is in keeping with policy and procedure.
- Schedules and reviews project tasks to ensure high quality product is delivered on time and within the budget.
- Engaged in clinical training activities and outcomes.
- Determines clinical and quality measures for success.
- Designs standardized protocols, develops policy, and ensures timely implementation with corporate and health plan input.
- Ensures monthly auditing is occurring with appropriate follow-up.
- Utilizes excellent verbal and written communication skills
- Utilizes advanced teambuilding and conflict resolution skills
- Performs other duties as required
**Job Qualifications**
**REQUIRED EDUCATION** :
Completion of an accredited Registered Nurse (RN) Program or Bachelor's Degree in Nursing
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- Minimum 7 years' experience in a healthcare environment with directly transferable skills highly preferred.
- Minimum 7 years' experience performing supervisory/management work including Clinical Operations.
- Experience with Contact Center operations.
- Experience managing professional staff in a clinical Contact Center.
- Experience managing process improvement activities.
**REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** :
Active, unrestricted State Registered Nursing (RN) license in good standing
**PREFERRED EXPERIENCE** :
+ 9 years' experience in a healthcare environment with directly transferable skills highly preferred
+ 9 years' experience performing supervisory/management work including Clinical Operations.
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: $97,299 - $227,679 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now
8
Clinical Operations Manager
83702 Hidden Springs, Idaho
$95000 Annually
WhatJobs
Posted 7 days ago
Job Viewed
Job Description
Our client, a leading non-profit organization dedicated to providing comprehensive support services, is seeking an experienced Clinical Operations Manager to oversee their therapeutic programs in Boise, Idaho, US . This is a hybrid role, blending remote work flexibility with essential in-person responsibilities. You will be responsible for the efficient and effective day-to-day operations of multiple clinical sites, ensuring the delivery of high-quality patient care. This includes managing staff, optimizing workflows, adhering to regulatory compliance, and contributing to program development and strategic planning. The ideal candidate will have a strong background in healthcare administration or clinical management, with a deep understanding of patient care delivery, operational efficiency, and regulatory requirements (e.g., HIPAA, state licensing). You will lead and mentor a team of healthcare professionals, fostering a positive and productive work environment. Responsibilities include budget management, resource allocation, quality improvement initiatives, and ensuring seamless coordination between clinical teams and administrative functions. The ability to develop and implement operational policies and procedures, troubleshoot complex challenges, and champion best practices in patient safety and satisfaction is paramount. This role requires excellent communication, organizational, and interpersonal skills. You will play a crucial role in ensuring that the organization's mission of providing exceptional community and social care services is met through optimized clinical operations.
Responsibilities:
Job Location: Boise, Idaho, US
Responsibilities:
- Manage the daily operations of clinical service delivery across multiple sites.
- Supervise, train, and mentor clinical and administrative staff.
- Develop and implement operational policies, procedures, and workflows.
- Ensure compliance with all relevant healthcare regulations and standards.
- Monitor and manage departmental budgets and resource allocation.
- Oversee quality improvement initiatives and patient satisfaction surveys.
- Facilitate effective communication and collaboration among clinical teams and departments.
- Troubleshoot operational issues and implement timely and effective solutions.
- Contribute to strategic planning and program development.
- Bachelor's degree in Healthcare Administration, Public Health, Business Administration, or a related field. Master's degree preferred.
- Minimum of 5 years of experience in healthcare management or clinical operations, preferably within community or social care settings.
- Demonstrated knowledge of healthcare regulations, compliance, and best practices.
- Strong leadership, team management, and interpersonal skills.
- Excellent organizational, problem-solving, and decision-making abilities.
- Proficiency in healthcare management software and electronic health records (EHR) systems.
- Budget management and financial oversight experience.
- Commitment to providing high-quality patient care and supporting community well-being.
Job Location: Boise, Idaho, US
Apply Now
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