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Physical Therapist

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Specialist, Quality Interventions/ QI Compliance

Molina Healthcare Bothell, WA
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Company: Molina Healthcare
Location: Bothell, WA
Career Level: Entry Level
Industries: Healthcare, Pharmaceutical, Biotech

Description



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
• Provides clerical, data entry and/or telephone support for the Utilization Management team.
• Manages the workflow for responses to incoming authorization requests and correspondence from Molina members and providers, collaborating with team members to provide timely replies.
• Generates, processes, tracks and stores authorization requests and correspondence related to Care Access and Monitoring approvals and denials and other integrated Molina programs including Behavioral Health and Long Term Care.
• Enters member demographic data and provider information updates into appropriate systems.
• Processes and monitors all denial letters through Molina denial database.

Qualifications

Job Qualifications Required Education
HS Diploma or GED
Required Experience
Min. 1 year experience in an administrative support role in healthcare.
Required License, Certification, Association
n/a
Preferred Education
Associate's Degree
Preferred Experience
3+ years experience in an administrative support role in healthcare, Medical Assistant preferred.
Preferred License, Certification, Association
n/a

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.
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