Salary Breakdown
Clinical Nurse Specialists
Average
$81,600
ANNUAL
$39.23
HOURLY
Entry Level
$60,750
ANNUAL
$29.21
HOURLY
Mid Level
$78,260
ANNUAL
$37.63
HOURLY
Expert Level
$100,200
ANNUAL
$48.18
HOURLY
Supporting Programs
Clinical Nurse Specialists
No Results
Current Available & Projected Jobs
Clinical Nurse Specialists
Top Expected Tasks
Clinical Nurse Specialists
01
Evaluate the quality and effectiveness of nursing practice or organizational systems.
02
Collaborate with other health care professionals and service providers to ensure optimal patient care.
03
Develop and maintain departmental policies, procedures, objectives, or patient care standards, based on evidence-based practice guidelines or expert opinion.
04
Develop nursing service philosophies, goals, policies, priorities, or procedures.
05
Direct or supervise nursing care staff in the provision of patient therapy.
06
Read current literature, talk with colleagues, or participate in professional organizations or conferences to keep abreast of developments in nursing.
07
Instruct nursing staff in areas such as the assessment, development, implementation, and evaluation of disability, illness, management, technology, or resources.
08
Provide coaching and mentoring to other caregivers to help facilitate their professional growth and development.
09
Provide consultation to other health care providers in areas such as patient discharge, patient care, or clinical procedures.
10
Develop, implement, or evaluate standards of nursing practice in specialty area, such as pediatrics, acute care, and geriatrics.
11
Maintain departmental policies, procedures, objectives, or infection control standards.
Knowledge, Skills & Abilities
Clinical Nurse Specialists
Common knowledge, skills & abilities needed to get a foot in the door.
KNOWLEDGE
Medicine and Dentistry
KNOWLEDGE
Education and Training
KNOWLEDGE
English Language
KNOWLEDGE
Biology
KNOWLEDGE
Psychology
SKILL
Active Listening
SKILL
Critical Thinking
SKILL
Reading Comprehension
SKILL
Service Orientation
SKILL
Active Learning
ABILITY
Deductive Reasoning
ABILITY
Oral Comprehension
ABILITY
Oral Expression
ABILITY
Written Comprehension
ABILITY
Inductive Reasoning
Job Opportunities
Clinical Nurse Specialists
-
Care Review Clinician, Inpatient Review (RN)
Molina Healthcare Scottsdale, AZ 85258Posted about 2 hours**JOB DESCRIPTION**
**Job Summary**
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
+ Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
+ Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
+ Conducts inpatient reviews to determine financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed.
+ Processes requests within required timelines.
+ Refers appropriate cases to Medical Directors and presents them in a consistent and efficient manner.
+ Requests additional information from members or providers in consistent and efficient manner.
+ Makes appropriate referrals to other clinical programs.
+ Collaborates with multidisciplinary teams to promote Molina Care Model.
+ Adheres to UM policies and procedures.
+ Occasional travel to other Molina offices or hospitals as requested, may be required. This can vary based on the individual State Plan.
**JOB QUALIFICATIONS**
**Required Education**
Graduate from an Accredited School of Nursing.
**Required Experience**
3+ years hospital acute care/medical experience.
**Required License, Certification, Association**
Active, unrestricted State Registered Nursing (RN) license in good standing.
**Preferred Experience**
Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.
**Preferred License, Certification, Association**
Active, unrestricted Utilization Management Certification (CPHM).
MULTI STATE / COMPACT LICENSURE
**WORK SCHEDULE: Mon - Fri / Sun - Thurs / Tues - Sat with some weekends and holidays.**
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: $26.41 - $61.79 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Employment TypeFull Time
-
Care Review Clinician, Inpatient Review (RN)
Molina Healthcare Tucson, AZ 85702Posted about 2 hours**JOB DESCRIPTION**
**Job Summary**
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
+ Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
+ Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
+ Conducts inpatient reviews to determine financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed.
+ Processes requests within required timelines.
+ Refers appropriate cases to Medical Directors and presents them in a consistent and efficient manner.
+ Requests additional information from members or providers in consistent and efficient manner.
+ Makes appropriate referrals to other clinical programs.
+ Collaborates with multidisciplinary teams to promote Molina Care Model.
+ Adheres to UM policies and procedures.
+ Occasional travel to other Molina offices or hospitals as requested, may be required. This can vary based on the individual State Plan.
**JOB QUALIFICATIONS**
**Required Education**
Graduate from an Accredited School of Nursing.
**Required Experience**
3+ years hospital acute care/medical experience.
**Required License, Certification, Association**
Active, unrestricted State Registered Nursing (RN) license in good standing.
**Preferred Experience**
Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.
**Preferred License, Certification, Association**
Active, unrestricted Utilization Management Certification (CPHM).
MULTI STATE / COMPACT LICENSURE
**WORK SCHEDULE: Mon - Fri / Sun - Thurs / Tues - Sat with some weekends and holidays.**
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: $26.41 - $61.79 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Employment TypeFull Time
-
RN Program Manager - Implementation
Molina Healthcare Mesa, AZ 85213Posted about 2 hours**JOB DESCRIPTION**
**Job Summary**
For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside.
Program Manager RN will be supporting our corporate division with Implementations within new and existing health plans. Looking for someone with excellent computer skills including creating documentation from scratch. This is a fast-paced position that will require someone who can work multiple projects/tasks simultaneously.
TRAVEL – Must be able to do business travels and go to new markets for implementation when needed.
Home office with internet connectivity of high speed required.
Schedule: Monday thru Friday 8:00AM to 5:00PM (Must be able to be flexible with schedule)
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ In collaboration with others, 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.
+ Manages programs providing ongoing communication of 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 the business.
+ Serves as a subject matter expert and leads programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
+ Works with operational leaders within the business to provide recommendations for process improvement opportunities.
+ Conducts quality audits to assess Molina Healthcare Services staff educational needs and service quality and implement quality initiatives within the department as appropriate.
+ Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
**JOB QUALIFICATIONS**
**Required Education**
+ Registered Nurse or equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license.
+ OR Bachelor's or master’s degree in Nursing, Gerontology, Public Health, Social Work or related field.
**Required Experience**
+ 5+ years of managed healthcare experience, including 3 or more years in one or more of the following areas: utilization management, case management, care transition and/or disease management.
+ Minimum 2 years of healthcare or health plan supervisory or managerial experience, including oversight of clinical staff.
+ Experience working within applicable state, federal, and third party regulations.
**Required License, Certification, Association**
+ If licensed, license must be active, unrestricted and in good standing.
+ Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
**Preferred Education**
Master's Degree preferred.
**Preferred Experience**
+ 3+ years supervisory/management experience in a managed healthcare environment.
+ Medicaid/Medicare Population experience with increasing responsibility.
+ 3+ years of clinical nursing experience.
**Preferred License, Certification, Association**
Any of the following:
Certified Case Manager (CCM), Certified Professional in Healthcare Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification.
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: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Employment TypeFull Time
-
Care Review Clinician, Inpatient Review (RN)
Molina Healthcare Mesa, AZ 85213Posted about 2 hours**JOB DESCRIPTION**
**Job Summary**
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
+ Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
+ Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
+ Conducts inpatient reviews to determine financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed.
+ Processes requests within required timelines.
+ Refers appropriate cases to Medical Directors and presents them in a consistent and efficient manner.
+ Requests additional information from members or providers in consistent and efficient manner.
+ Makes appropriate referrals to other clinical programs.
+ Collaborates with multidisciplinary teams to promote Molina Care Model.
+ Adheres to UM policies and procedures.
+ Occasional travel to other Molina offices or hospitals as requested, may be required. This can vary based on the individual State Plan.
**JOB QUALIFICATIONS**
**Required Education**
Graduate from an Accredited School of Nursing.
**Required Experience**
3+ years hospital acute care/medical experience.
**Required License, Certification, Association**
Active, unrestricted State Registered Nursing (RN) license in good standing.
**Preferred Experience**
Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.
**Preferred License, Certification, Association**
Active, unrestricted Utilization Management Certification (CPHM).
MULTI STATE / COMPACT LICENSURE
**WORK SCHEDULE: Mon - Fri / Sun - Thurs / Tues - Sat with some weekends and holidays.**
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: $26.41 - $61.79 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Employment TypeFull Time
-
RN Program Manager - Implementation
Molina Healthcare Phoenix, AZ 85067Posted about 2 hours**JOB DESCRIPTION**
**Job Summary**
For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside.
Program Manager RN will be supporting our corporate division with Implementations within new and existing health plans. Looking for someone with excellent computer skills including creating documentation from scratch. This is a fast-paced position that will require someone who can work multiple projects/tasks simultaneously.
TRAVEL – Must be able to do business travels and go to new markets for implementation when needed.
Home office with internet connectivity of high speed required.
Schedule: Monday thru Friday 8:00AM to 5:00PM (Must be able to be flexible with schedule)
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ In collaboration with others, 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.
+ Manages programs providing ongoing communication of 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 the business.
+ Serves as a subject matter expert and leads programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
+ Works with operational leaders within the business to provide recommendations for process improvement opportunities.
+ Conducts quality audits to assess Molina Healthcare Services staff educational needs and service quality and implement quality initiatives within the department as appropriate.
+ Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
**JOB QUALIFICATIONS**
**Required Education**
+ Registered Nurse or equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license.
+ OR Bachelor's or master’s degree in Nursing, Gerontology, Public Health, Social Work or related field.
**Required Experience**
+ 5+ years of managed healthcare experience, including 3 or more years in one or more of the following areas: utilization management, case management, care transition and/or disease management.
+ Minimum 2 years of healthcare or health plan supervisory or managerial experience, including oversight of clinical staff.
+ Experience working within applicable state, federal, and third party regulations.
**Required License, Certification, Association**
+ If licensed, license must be active, unrestricted and in good standing.
+ Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
**Preferred Education**
Master's Degree preferred.
**Preferred Experience**
+ 3+ years supervisory/management experience in a managed healthcare environment.
+ Medicaid/Medicare Population experience with increasing responsibility.
+ 3+ years of clinical nursing experience.
**Preferred License, Certification, Association**
Any of the following:
Certified Case Manager (CCM), Certified Professional in Healthcare Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification.
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: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Employment TypeFull Time
-
RN Program Manager - Implementation
Molina Healthcare Tucson, AZ 85702Posted about 2 hours**JOB DESCRIPTION**
**Job Summary**
For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside.
Program Manager RN will be supporting our corporate division with Implementations within new and existing health plans. Looking for someone with excellent computer skills including creating documentation from scratch. This is a fast-paced position that will require someone who can work multiple projects/tasks simultaneously.
TRAVEL – Must be able to do business travels and go to new markets for implementation when needed.
Home office with internet connectivity of high speed required.
Schedule: Monday thru Friday 8:00AM to 5:00PM (Must be able to be flexible with schedule)
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ In collaboration with others, 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.
+ Manages programs providing ongoing communication of 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 the business.
+ Serves as a subject matter expert and leads programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
+ Works with operational leaders within the business to provide recommendations for process improvement opportunities.
+ Conducts quality audits to assess Molina Healthcare Services staff educational needs and service quality and implement quality initiatives within the department as appropriate.
+ Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
**JOB QUALIFICATIONS**
**Required Education**
+ Registered Nurse or equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license.
+ OR Bachelor's or master’s degree in Nursing, Gerontology, Public Health, Social Work or related field.
**Required Experience**
+ 5+ years of managed healthcare experience, including 3 or more years in one or more of the following areas: utilization management, case management, care transition and/or disease management.
+ Minimum 2 years of healthcare or health plan supervisory or managerial experience, including oversight of clinical staff.
+ Experience working within applicable state, federal, and third party regulations.
**Required License, Certification, Association**
+ If licensed, license must be active, unrestricted and in good standing.
+ Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
**Preferred Education**
Master's Degree preferred.
**Preferred Experience**
+ 3+ years supervisory/management experience in a managed healthcare environment.
+ Medicaid/Medicare Population experience with increasing responsibility.
+ 3+ years of clinical nursing experience.
**Preferred License, Certification, Association**
Any of the following:
Certified Case Manager (CCM), Certified Professional in Healthcare Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification.
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: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Employment TypeFull Time
-
Care Review Clinician, Inpatient Review (RN)
Molina Healthcare Phoenix, AZ 85067Posted about 2 hours**JOB DESCRIPTION**
**Job Summary**
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
+ Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
+ Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
+ Conducts inpatient reviews to determine financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed.
+ Processes requests within required timelines.
+ Refers appropriate cases to Medical Directors and presents them in a consistent and efficient manner.
+ Requests additional information from members or providers in consistent and efficient manner.
+ Makes appropriate referrals to other clinical programs.
+ Collaborates with multidisciplinary teams to promote Molina Care Model.
+ Adheres to UM policies and procedures.
+ Occasional travel to other Molina offices or hospitals as requested, may be required. This can vary based on the individual State Plan.
**JOB QUALIFICATIONS**
**Required Education**
Graduate from an Accredited School of Nursing.
**Required Experience**
3+ years hospital acute care/medical experience.
**Required License, Certification, Association**
Active, unrestricted State Registered Nursing (RN) license in good standing.
**Preferred Experience**
Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.
**Preferred License, Certification, Association**
Active, unrestricted Utilization Management Certification (CPHM).
MULTI STATE / COMPACT LICENSURE
**WORK SCHEDULE: Mon - Fri / Sun - Thurs / Tues - Sat with some weekends and holidays.**
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: $26.41 - $61.79 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Employment TypeFull Time
-
Care Review Clinician, Inpatient Review (RN)
Molina Healthcare Chandler, AZ 85286Posted about 2 hours**JOB DESCRIPTION**
**Job Summary**
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
+ Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
+ Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
+ Conducts inpatient reviews to determine financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed.
+ Processes requests within required timelines.
+ Refers appropriate cases to Medical Directors and presents them in a consistent and efficient manner.
+ Requests additional information from members or providers in consistent and efficient manner.
+ Makes appropriate referrals to other clinical programs.
+ Collaborates with multidisciplinary teams to promote Molina Care Model.
+ Adheres to UM policies and procedures.
+ Occasional travel to other Molina offices or hospitals as requested, may be required. This can vary based on the individual State Plan.
**JOB QUALIFICATIONS**
**Required Education**
Graduate from an Accredited School of Nursing.
**Required Experience**
3+ years hospital acute care/medical experience.
**Required License, Certification, Association**
Active, unrestricted State Registered Nursing (RN) license in good standing.
**Preferred Experience**
Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.
**Preferred License, Certification, Association**
Active, unrestricted Utilization Management Certification (CPHM).
MULTI STATE / COMPACT LICENSURE
**WORK SCHEDULE: Mon - Fri / Sun - Thurs / Tues - Sat with some weekends and holidays.**
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: $26.41 - $61.79 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Employment TypeFull Time
-
RN Program Manager - Implementation
Molina Healthcare Chandler, AZ 85286Posted about 2 hours**JOB DESCRIPTION**
**Job Summary**
For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside.
Program Manager RN will be supporting our corporate division with Implementations within new and existing health plans. Looking for someone with excellent computer skills including creating documentation from scratch. This is a fast-paced position that will require someone who can work multiple projects/tasks simultaneously.
TRAVEL – Must be able to do business travels and go to new markets for implementation when needed.
Home office with internet connectivity of high speed required.
Schedule: Monday thru Friday 8:00AM to 5:00PM (Must be able to be flexible with schedule)
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ In collaboration with others, 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.
+ Manages programs providing ongoing communication of 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 the business.
+ Serves as a subject matter expert and leads programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
+ Works with operational leaders within the business to provide recommendations for process improvement opportunities.
+ Conducts quality audits to assess Molina Healthcare Services staff educational needs and service quality and implement quality initiatives within the department as appropriate.
+ Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
**JOB QUALIFICATIONS**
**Required Education**
+ Registered Nurse or equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license.
+ OR Bachelor's or master’s degree in Nursing, Gerontology, Public Health, Social Work or related field.
**Required Experience**
+ 5+ years of managed healthcare experience, including 3 or more years in one or more of the following areas: utilization management, case management, care transition and/or disease management.
+ Minimum 2 years of healthcare or health plan supervisory or managerial experience, including oversight of clinical staff.
+ Experience working within applicable state, federal, and third party regulations.
**Required License, Certification, Association**
+ If licensed, license must be active, unrestricted and in good standing.
+ Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
**Preferred Education**
Master's Degree preferred.
**Preferred Experience**
+ 3+ years supervisory/management experience in a managed healthcare environment.
+ Medicaid/Medicare Population experience with increasing responsibility.
+ 3+ years of clinical nursing experience.
**Preferred License, Certification, Association**
Any of the following:
Certified Case Manager (CCM), Certified Professional in Healthcare Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification.
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: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Employment TypeFull Time
-
RN Program Manager - Implementation
Molina Healthcare Scottsdale, AZ 85258Posted about 2 hours**JOB DESCRIPTION**
**Job Summary**
For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside.
Program Manager RN will be supporting our corporate division with Implementations within new and existing health plans. Looking for someone with excellent computer skills including creating documentation from scratch. This is a fast-paced position that will require someone who can work multiple projects/tasks simultaneously.
TRAVEL – Must be able to do business travels and go to new markets for implementation when needed.
Home office with internet connectivity of high speed required.
Schedule: Monday thru Friday 8:00AM to 5:00PM (Must be able to be flexible with schedule)
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ In collaboration with others, 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.
+ Manages programs providing ongoing communication of 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 the business.
+ Serves as a subject matter expert and leads programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
+ Works with operational leaders within the business to provide recommendations for process improvement opportunities.
+ Conducts quality audits to assess Molina Healthcare Services staff educational needs and service quality and implement quality initiatives within the department as appropriate.
+ Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
**JOB QUALIFICATIONS**
**Required Education**
+ Registered Nurse or equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license.
+ OR Bachelor's or master’s degree in Nursing, Gerontology, Public Health, Social Work or related field.
**Required Experience**
+ 5+ years of managed healthcare experience, including 3 or more years in one or more of the following areas: utilization management, case management, care transition and/or disease management.
+ Minimum 2 years of healthcare or health plan supervisory or managerial experience, including oversight of clinical staff.
+ Experience working within applicable state, federal, and third party regulations.
**Required License, Certification, Association**
+ If licensed, license must be active, unrestricted and in good standing.
+ Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
**Preferred Education**
Master's Degree preferred.
**Preferred Experience**
+ 3+ years supervisory/management experience in a managed healthcare environment.
+ Medicaid/Medicare Population experience with increasing responsibility.
+ 3+ years of clinical nursing experience.
**Preferred License, Certification, Association**
Any of the following:
Certified Case Manager (CCM), Certified Professional in Healthcare Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification.
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: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Employment TypeFull Time
Related Careers & Companies
Health Sciences
Not sure where to begin?
Career Exploration