Patient Service Specialist Jobs at Molina Healthcare with Visa Sponsorship
Patient Service Specialist jobs at Molina Healthcare sit at the front line of managed care operations, handling member enrollment, benefits navigation, and care coordination. Molina has a documented history of sponsoring work visas for this function, making it a realistic target for international candidates in healthcare support.
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Get Access To All JobsJOB SUMMARY
Leads and supervises a multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or special programs. Ensures members reach desired outcomes through integrated delivery and coordination of care across the continuum, and contributes to overarching strategy to provide quality and cost-effective member care.
ESSENTIAL JOB DUTIES
- Oversees team performance for one or more of the following healthcare services functions: care management, utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), transition of care, behavioral health, long-term services and supports (LTSS), and/or special programs.
- Facilitates integrated, proactive healthcare services management - ensuring compliance with state and federal regulatory and accrediting standards and implementation of the Molina clinical model.
- Functions as a “hands-on” leader - assisting with assessing and evaluation of systems, day-to-day operations and efficiency of services/care delivery.
- Ensures adequate staffing and service levels and maintains customer satisfaction by implementing and monitoring staff productivity and other performance indicators.
- Assists in implementing care management, utilization management, behavioral health, care transitions, LTSS and other program activities in accordance with regulatory, contract standards and accreditation compliance.
- Ensures delivery of member care and services are aligned with Molina's established standards of customer service excellence.
- Ensures high-risk, complex members are adequately supported.
- Oversees ongoing monitoring of performance, protocols and guidelines related to healthcare services.
- Collaborates with and keeps senior level healthcare services leadership apprised of operational issues, staffing, resources, system and program needs.
- Performs and promotes interdepartmental/multidisciplinary integration and collaboration to enhance continuity of care.
- Oversees interdisciplinary care team (ICT) meetings.
- Analyzes and reports on care access and monitoring statistics including plan utilization, staff productivity, cost-effective utilization of services, management of targeted member population, and triage activities.
- Ensures completion of staff quality audit reviews evaluates services provided, outcomes achieved and recommends enhancements/improvements for programs and staff development to ensure consistent cost-effectiveness and compliance with all state and federal regulations and guidelines.
- Maintains professional relationships with provider community, internal and external customers, and state agencies as appropriate.
- Identifies opportunities for care delivery/quality/operational/etc. process improvements.
- Hires, trains, develops and manages team demonstrates accountability for team performance and achievement of department-specific goals.
- Local travel may be required (based upon state/contractual requirements).
REQUIRED QUALIFICATIONS
- At least 5 years of health care experience, including at least 2 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or special programs, or equivalent combination of relevant education and experience, or equivalent combination of relevant education and experience.
- Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
- Strong customer service skills/member-centric focus.
- Ability to work within a variety of settings and adjust style as needed, including ability to work with diverse populations, various personalities and personal situations.
- Ability to prioritize and manage multiple deadlines.
- Strong organizational and problem-solving skills.
- Ability to collaborate cross-functionally within a highly matrixed organization.
- Strong written and verbal communication skills.
- Microsoft Office suite and applicable software program(s) proficiency.
PREFERRED QUALIFICATIONS
- Management/leadership experience.
- Clinical experience.
- Registered Nurse (RN) or master's level behavioral health (BH) licensure. License must be active and unrestricted in state of practice.
- Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification.
- Medicaid/Medicare population 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
- Pay Range: $66,456 - $129,590 / ANNUAL
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
JOB SUMMARY
Leads and supervises a multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or special programs. Ensures members reach desired outcomes through integrated delivery and coordination of care across the continuum, and contributes to overarching strategy to provide quality and cost-effective member care.
ESSENTIAL JOB DUTIES
- Oversees team performance for one or more of the following healthcare services functions: care management, utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), transition of care, behavioral health, long-term services and supports (LTSS), and/or special programs.
- Facilitates integrated, proactive healthcare services management - ensuring compliance with state and federal regulatory and accrediting standards and implementation of the Molina clinical model.
- Functions as a “hands-on” leader - assisting with assessing and evaluation of systems, day-to-day operations and efficiency of services/care delivery.
- Ensures adequate staffing and service levels and maintains customer satisfaction by implementing and monitoring staff productivity and other performance indicators.
- Assists in implementing care management, utilization management, behavioral health, care transitions, LTSS and other program activities in accordance with regulatory, contract standards and accreditation compliance.
- Ensures delivery of member care and services are aligned with Molina's established standards of customer service excellence.
- Ensures high-risk, complex members are adequately supported.
- Oversees ongoing monitoring of performance, protocols and guidelines related to healthcare services.
- Collaborates with and keeps senior level healthcare services leadership apprised of operational issues, staffing, resources, system and program needs.
- Performs and promotes interdepartmental/multidisciplinary integration and collaboration to enhance continuity of care.
- Oversees interdisciplinary care team (ICT) meetings.
- Analyzes and reports on care access and monitoring statistics including plan utilization, staff productivity, cost-effective utilization of services, management of targeted member population, and triage activities.
- Ensures completion of staff quality audit reviews evaluates services provided, outcomes achieved and recommends enhancements/improvements for programs and staff development to ensure consistent cost-effectiveness and compliance with all state and federal regulations and guidelines.
- Maintains professional relationships with provider community, internal and external customers, and state agencies as appropriate.
- Identifies opportunities for care delivery/quality/operational/etc. process improvements.
- Hires, trains, develops and manages team demonstrates accountability for team performance and achievement of department-specific goals.
- Local travel may be required (based upon state/contractual requirements).
REQUIRED QUALIFICATIONS
- At least 5 years of health care experience, including at least 2 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or special programs, or equivalent combination of relevant education and experience, or equivalent combination of relevant education and experience.
- Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
- Strong customer service skills/member-centric focus.
- Ability to work within a variety of settings and adjust style as needed, including ability to work with diverse populations, various personalities and personal situations.
- Ability to prioritize and manage multiple deadlines.
- Strong organizational and problem-solving skills.
- Ability to collaborate cross-functionally within a highly matrixed organization.
- Strong written and verbal communication skills.
- Microsoft Office suite and applicable software program(s) proficiency.
PREFERRED QUALIFICATIONS
- Management/leadership experience.
- Clinical experience.
- Registered Nurse (RN) or master's level behavioral health (BH) licensure. License must be active and unrestricted in state of practice.
- Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification.
- Medicaid/Medicare population 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
- Pay Range: $66,456 - $129,590 / ANNUAL
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
See all Patient Service Specialist Jobs at Molina Healthcare
Sign up for free to unlock all listings, filter by visa type, and get alerts for new Patient Service Specialist Jobs at Molina Healthcare.
Get Access To All JobsTips for Finding Patient Service Specialist Jobs at Molina Healthcare
Certify Your Healthcare Credentials Before Applying
Molina operates across Medicaid, Medicare, and Marketplace plans, so certifications like CPHQ or a Medical Administrative Assistant credential signal direct readiness. Having these verified and documented before you apply removes friction from any later sponsorship conversation.
Target Molina's State-Specific Medicaid Contracts
Molina staffs Patient Service Specialists by state contract, not by a single national pipeline. Search by state where Molina holds active Medicaid managed care contracts, as those markets have the most consistent open headcount and sponsorship activity for this role.
Use Migrate Mate to Filter Sponsor-Confirmed Openings
Not every Patient Service Specialist posting at Molina is tied to active sponsorship capacity. Use Migrate Mate to surface only the roles where Molina has a confirmed visa sponsorship track record, so you spend time on applications that can actually move forward.
Clarify OPT or TN Eligibility in Your Application
If you're on F-1 OPT or qualify for TN status, state it upfront when applying. Healthcare operations roles like this one can qualify under TN's medical technologist categories, and Molina's recruiting team needs to route your file to the right internal contact from the start.
Align Your Offer Letter to DOL Prevailing Wage Standards
Before signing an offer, cross-check the proposed salary against the DOL prevailing wage for Patient Service Specialist roles in that specific state. If the wage is below the prevailing rate, the Labor Condition Application required for H-1B sponsorship cannot be certified.
Request a PERM Timeline Discussion Before Your Start Date
If you're targeting Green Card sponsorship through EB-2 or EB-3, ask Molina's HR team early whether they initiate PERM recruitment concurrently with onboarding or only after a waiting period. The PERM process can take 12 to 18 months or longer before USCIS even receives the petition.
Frequently Asked Questions
Does Molina Healthcare sponsor H-1B visas for Patient Service Specialists?
Yes, Molina Healthcare has a track record of H-1B visa sponsorship for Patient Service Specialist roles. Sponsorship availability depends on the specific position, the state market, and whether the role meets USCIS specialty occupation criteria. Candidates should confirm sponsorship intent directly with Molina's recruiter during the initial screening call, before investing time in multi-round interviews.
How do I apply for Patient Service Specialist jobs at Molina Healthcare?
Applications go through Molina Healthcare's careers portal, where roles are posted by state and line of business. For international candidates, Migrate Mate filters Patient Service Specialist openings specifically where Molina has demonstrated visa sponsorship activity, helping you prioritize the applications most likely to result in a sponsorship offer rather than applying to every open listing.
Which visa types does Molina Healthcare commonly use for Patient Service Specialist roles?
Molina has sponsored H-1B visas and supported F-1 OPT and CPT for Patient Service Specialist positions. TN visa status is also viable for Canadian and Mexican nationals if the role maps to a qualifying USMCA occupation category. For longer-term pathways, Molina has initiated EB-2 and EB-3 Green Card sponsorship for employees in this function who meet the relevant experience thresholds.
What qualifications does Molina Healthcare expect for Patient Service Specialist positions?
Most Patient Service Specialist roles at Molina require at least a high school diploma or GED, though associate or bachelor's degrees in health administration or a related field strengthen your profile. Direct experience in managed care, Medicaid member services, or medical call center environments is heavily weighted. Bilingual ability in Spanish is frequently listed as preferred, particularly for state contracts serving high-density Hispanic populations.
How do I understand the visa sponsorship timeline for a Patient Service Specialist role at Molina?
Timeline depends on visa type. F-1 OPT can begin on your employment start date if your EAD is already approved. H-1B sponsorship requires filing with USCIS during the annual cap window, with an October 1 start date at the earliest. PERM-based Green Card cases add 12 to 24 months before USCIS adjudication even begins. Confirm which pathway Molina intends to use before accepting an offer.