Job Summary: The Manager, Ohio Market Contracting is responsible for leading specialized contracting efforts, handle unique contracting situations, including facilitating contracting changes and negotiations. Essential Functions: - Responsible for tracking and trending, inventory and priorities - Assists with the development and evolution of the team’s strategic direction, annual goals and objectives; recommends new processes and changes for increased department productivity - Establish and maintain strong working relationships with key internal business partners - Develop and report on key accomplishments and issues to upper management - Lead cross-functional workgroups for special priority contracts, create and manage work plans, and facilitate the removal of barriers to ensure timely implementation of key contracts and providers - Conduct project team meetings to establish and execute on detailed project plans - Report on key initiatives and accomplishments to leadership, including PowerPoint report outs - Ensure proper documentation and SOPs are followed by staff - Implement and maintain key metrics for staff performance - Manage day to day operations of direct reports, to include hiring decisions, performance management, training and staff development - Participate in network provider meetings, attend key committees, subcommittees, and/or workgroups as necessary - Manage multiple projects, collect and analyze data and disseminate to appropriate departments as necessary - Ensure appropriate documentation of interactions and projects by all team members - Coordinate contract language change requests to ensure template accuracy and utilization - Perform any other job duties as requested Education and Experience: - Bachelor’s Degree in Business Administration or related field, or equivalent years of relevant work experience is required - A minimum of three (3) years of progressive experience in health care or managed care is required - Experience in provider relations or contracting is required - Previous management experience is preferred - Post-acute provider experience is preferred Competencies, Knowledge and Skills: - Proficient with Microsoft Office to include Word, Excel and PowerPoint - Excellent written and verbal communications skills - Ability to develop, prioritize and accomplish goals - Detail oriented - Strong interpersonal skills and high level of professionalism - Effective listening and critical thinking skills - Effective problem solving skills with attention to detail - Ability to work independently and within a team - Strong negotiation skills - Excellent leadership skills - Ability to create and maintain excellent working relationships - Excellent research and analytical skills - Business Analysis skills Licensure and Certification: - Valid driver’s license is required; employment in this position is conditional pending successful clearance of a driver’s license record check. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if you have started employment in this position, your employment in this position will be terminated - To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified. - CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process. Working Conditions: - General office environment; may be required to sit or stand for extended periods of time Compensation Range: $83,000.00 - $132,800.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-TS1

• Serve as the clinical lead for a team of NPs and oversee their work • Focus on onboarding and oversight of NPs and care delivery to improve clinical outcomes • Support ongoing training for NPs through clinical best practice exercises • Work with IKC Medical Officer on clinical and operational strategy • Lead complex case reviews and timely support of complex case escalations • Comply with DaVita policies and procedures in accordance with State and Federal regulations

Vālenz® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible. About This Opportunity: As a Supervisor of Utilization Management, you will lead a team of utilization review nurses by providing guidance, mentorship, and training to ensure timely, high-quality clinical reviews. Using your leadership and clinical expertise, you will collaborate with organizational leaders to refine utilization management policies, support adherence to evidence-based guidelines, and promote a culture of continuous improvement. In this role, you will conduct clinical reviews, ensure regulatory compliance, and facilitate communication with providers and payers. You will also monitor team performance, coach staff for professional growth, and identify opportunities for quality improvement and cost containment, while consistently upholding professional and ethical standards. Things You’ll Do Here: - Supervise and support a team of Utilization Review Nurses, providing guidance, mentorship, and ongoing training. - Collaborate with leadership to develop, implement, and maintain UM policies, procedures, and clinical guidelines. - Monitor team performance against established productivity and quality goals, ensuring timely and accurate work. - Deliver clear communication, coaching, and educational support to enhance team performance and compliance. - Conduct clinical reviews to assess medical necessity and appropriateness of services, referring to Case Management or other programs as needed. - Evaluate treatment plans and medical records to ensure alignment with evidence-based criteria and best practices. - Ensure timely communication of utilization decisions with healthcare providers, payers, and clients. - Collaborate with providers and internal teams to promote efficient resource use and identify opportunities for quality improvement and cost containment. - Ensure compliance with regulatory requirements and accreditation standards including Medicare, Medicaid, and URAC. - Maintain complete, accurate documentation of all UM activities and decisions. - Stay current with industry regulations, standards, and emerging best practices in utilization management. - Uphold strict confidentiality and demonstrate high standards of professional and ethical conduct. - Perform other duties as assigned. Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties. What You’ll Bring to the Team: - 5+ years of Utilization Management or Quality Improvement experience in managed care. - 2+ years of clinical experience in an acute care or surgical hospital setting. - Active RN license in the state of residence. - Proficient in ICD-10, CPT, HCPCS, Revenue codes, and CMS/URAC guidelines. - Familiar with evidence-based criteria such as MCG and health plan policies. - Strong relationship-building skills with clear, effective communication. - Able to thrive in a fast-paced, detail-oriented, deadline-driven environment. A plus if you have: - Health insurance experience - Prior leadership experience - MCG certification - Compact State Nursing License Where You’ll Work: This is a fully remote position, and we’ll provide all the necessary equipment! - Work Environment: You’ll need a quiet workspace that is free from distractions. - Technology: Reliable internet connection—if you can use streaming services, you’re good to go! - Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software. - Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA. Why You'll Love Working Here Valenz is proud to be recognized by Inc. 5000 as one of America’s fastest-growing private companies. Our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare. With this commitment, you’ll find an engaged culture – one that stands strong, vigorous, and healthy in all we do. Benefits - Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card. - Spending account options: HSA, FSA, and DCFSA - 401K with company match and immediate vesting - Flexible working environment - Generous Paid Time Off to include vacation, sick leave, and paid holidays - Employee Assistance Program that includes professional counseling, referrals, and additional services - Paid maternity and paternity leave - Pet insurance - Employee discounts on phone plans, car rentals and computers - Community giveback opportunities, including paid time off for philanthropic endeavors At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.

This is a remote field-based role requiring travel within Calhoun and Carroll counties. Due to contractual requirements with Iowa, we are unable to hire LPN/LVNs for this role. Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. • Facilitates comprehensive waiver enrollment and disenrollment processes. • Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. • Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. • Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care. • Assesses for medical necessity and authorizes all appropriate waiver services. • Evaluates covered benefits and advises appropriately regarding funding sources. • Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration. • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. • Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. • Identifies critical incidents and develops prevention plans to assure member health and welfare. • Collaborates with licensed care managers/leadership as needed or required. • 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. •Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). 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. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • Demonstrated knowledge of community resources. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to operate proactively and demonstrate detail-oriented work. • Ability to work independently, with minimal supervision and self-motivation. • Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving, and critical-thinking skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). Preferred Qualifications • Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. • Experience working with populations that receive waiver services. 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