{"schemaVersion":"jobsearcher.job.v1","id":"ba2aacd40a80ffebdd4ca19c","url":"https://jobsearcher.com/jobs/ba2aacd40a80ffebdd4ca19c","canonicalUrl":"https://jobsearcher.com/jobs/ba2aacd40a80ffebdd4ca19c","title":"Clinical Design Specialist ( RN- Pediatrics)","description":"**JOB DESCRIPTION****Job Summary**Provides subject matter expertise and leadership in clinical design and population health initiatives, supporting execution/operationalization and implementation, providing evaluation and support for post-implementation process, and ensuring compliance with regulatory and internal standards, practices, policies, and contractual commitments. Contributes to the overarching strategy in providing quality and cost-effective member care to single and multiple member population with a focus on pediatric population health and wellbeing.**Essential Job Duties**+ Supports Population Health Transformation and integrated clinical model concept design.+ Lead clinical design and population health projects: Collaboratively plan and execute initiatives that strengthen care management, transitions of care, and population health strategies across multiple markets.+ Develop and standardize workflows: Design and implement clinical workflows, tools, and protocols that promote whole-person, timely, and coordinated care.+ Drive process improvement and change management: Identify opportunities for efficiency and quality improvement, ensuring alignment with organizational goals and compliance requirements.+ Serve as a clinical subject matter expert: Provide guidance on best practices for care management, including cross functional teams such as utilization management, and quality.+ Communicate and align strategy: Partner with stakeholders to share clinical and operational needs into actionable requirements, ensuring consistent messaging and adoption.+ Create supporting documentation: Develop business requirements, test plans, training materials, and other resources to support program execution and sustainability.+ Collaboratively plans and executes internal healthcare services projects and programs involving department or cross-functional teams of subject matter experts, delivering products from the design process to completion.+ Provides ongoing communication related to program goals, evaluation, and support to ensure compliance with standardized protocols and processes.+ May engage and oversee the work of external vendors.**Required Qualifications**+ At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience.+ Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Licensed Clinicians to include backgrounds such as MSW, LCSWs etc.+ 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 analytical and problem-solving skills.+ Strong organizational and time-management skills.+ Ability to work in a cross-functional, professional environment.+ Experience working within applicable state, federal, and third-party regulations.+ Strong verbal and written communication skills.+ Microsoft Office program proficiency, and ability to navigate online portals and databases.**Preferred Qualifications**+ Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification.+ Experience creating executive summaries and decks as well as comfort presenting to varying stakeholders and audiences, including executive leadership+ Clinical nursing experience+ Leadership and change management experience.+ Medicaid/Medicare/Duals population experience.+ Six Sigma Green Belt or higher certification+ Pediatric experience in a children's hospital or specialty medical setting+ Strong command of writing and editing.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: $65,791 - $142,548 / ANNUAL*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.","company":"Molina Healthcare","rawCompany":"molina healthcare","city":"Long Beach","state":"CA","isRemote":false,"isActive":false,"createdAt":"2026-05-21T04:35:35.753Z","occupations":[{"code":"29-1141.04","title":"Clinical Nurse Specialists","slug":"clinical-nurse-specialists"},{"code":"29-1141.00","title":"Registered Nurses","slug":"registered-nurses"},{"code":"11-9111.00","title":"Medical and Health Services Managers","slug":"medical-and-health-services-managers"}],"industries":[{"code":"622110","title":"General Medical and Surgical Hospitals","slug":"general-medical-and-surgical-hospitals"},{"code":"621498","title":"All Other Outpatient Care Centers","slug":"all-other-outpatient-care-centers"},{"code":"622310","title":"Specialty (except Psychiatric and Substance Abuse) Hospitals","slug":"specialty-except-psychiatric-and-substance-abuse-hospitals"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Clinical Design Specialist ( RN- Pediatrics)","description":"**JOB DESCRIPTION****Job Summary**Provides subject matter expertise and leadership in clinical design and population health initiatives, supporting execution/operationalization and implementation, providing evaluation and support for post-implementation process, and ensuring compliance with regulatory and internal standards, practices, policies, and contractual commitments. Contributes to the overarching strategy in providing quality and cost-effective member care to single and multiple member population with a focus on pediatric population health and wellbeing.**Essential Job Duties**+ Supports Population Health Transformation and integrated clinical model concept design.+ Lead clinical design and population health projects: Collaboratively plan and execute initiatives that strengthen care management, transitions of care, and population health strategies across multiple markets.+ Develop and standardize workflows: Design and implement clinical workflows, tools, and protocols that promote whole-person, timely, and coordinated care.+ Drive process improvement and change management: Identify opportunities for efficiency and quality improvement, ensuring alignment with organizational goals and compliance requirements.+ Serve as a clinical subject matter expert: Provide guidance on best practices for care management, including cross functional teams such as utilization management, and quality.+ Communicate and align strategy: Partner with stakeholders to share clinical and operational needs into actionable requirements, ensuring consistent messaging and adoption.+ Create supporting documentation: Develop business requirements, test plans, training materials, and other resources to support program execution and sustainability.+ Collaboratively plans and executes internal healthcare services projects and programs involving department or cross-functional teams of subject matter experts, delivering products from the design process to completion.+ Provides ongoing communication related to program goals, evaluation, and support to ensure compliance with standardized protocols and processes.+ May engage and oversee the work of external vendors.**Required Qualifications**+ At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience.+ Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Licensed Clinicians to include backgrounds such as MSW, LCSWs etc.+ 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 analytical and problem-solving skills.+ Strong organizational and time-management skills.+ Ability to work in a cross-functional, professional environment.+ Experience working within applicable state, federal, and third-party regulations.+ Strong verbal and written communication skills.+ Microsoft Office program proficiency, and ability to navigate online portals and databases.**Preferred Qualifications**+ Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification.+ Experience creating executive summaries and decks as well as comfort presenting to varying stakeholders and audiences, including executive leadership+ Clinical nursing experience+ Leadership and change management experience.+ Medicaid/Medicare/Duals population experience.+ Six Sigma Green Belt or higher certification+ Pediatric experience in a children's hospital or specialty medical setting+ Strong command of writing and editing.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: $65,791 - $142,548 / ANNUAL*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.","datePosted":"2026-05-21T04:35:35.753Z","dateModified":"2026-05-21T04:35:35.753Z","hiringOrganization":{"@type":"Organization","name":"Molina Healthcare","sameAs":"https://jobsearcher.com"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Long Beach","addressRegion":"CA","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"ba2aacd40a80ffebdd4ca19c"},"url":"https://jobsearcher.com/jobs/ba2aacd40a80ffebdd4ca19c"}}