Jobs at Molina Healthcare in Albuquerque, NM

21 job openings within 25 miles

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Marketplace Lead, Call Center

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryProvides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and service information to members, and identifies opportunities to maintain and increase member rela...

Dir, Healthcare Services

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryMolina 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 ...

Claims Representative- (Call / Contact Center)

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryProvides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and service information to members, and identifies opportunities to maintain and increase member rela...

Care Review Clinician, Prior Authorization

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryMolina 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 ...

Care Review Processor

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryMolina 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 ...

Bilingual Contact Center Associate Rep

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryProvides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and service information to members, and identifies opportunities to maintain and increase member rela...

Lead, Call Center

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryProvides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and service information to members, and identifies opportunities to maintain and increase member rel...

Clinical Appeals Nurse (RN)

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryClinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance standards.Knowledge/Skills/Abilities• The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals request has been made or up...

Marketplace, Member Rep I ( Call / Contact Center )

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryProvide new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolve member inquiries and complaints fairly and effectively. Provide product and service information to members, and identifies opportunities to maintain and increase member relatio...

Care Review Clinician, Inpatient Review (RN)

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryMolina 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 ...

Sr Rep, Provider Services

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryMolina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provi...

Sr Account Rep, Medicare (Albuquerque, Santa Fe, Gallup, and Farmington)

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryResponsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within approved market areas to achieve stated revenue, profitability and retention goals, while following ethical sales practices and adhering to established policies and procedur...

Provider Contracts Spc

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryProvides contracting expertise in the realm of providers.Knowledge/Skills/Abilities• Responsible for the negotiation of contracts and letters of agreements with hospitals, physician groups and ancillary providers that result in high quality, cost effective and marketable providers.• Initiates, negotiates...

Assoc Specialist, Appeals & Grievances

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryMolina Healthcare's Appeals & Grievances jobs are responsible for reviewing and resolving member complaints and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid.Knowledge/Skills/Abilities• ...

Sr Project Manager

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryManages people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May...