Jobs at Molina Healthcare in Bothell, WA

20 job openings within 25 miles

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Supervisor, Utilization Management - Care Review (RN)

Molina Healthcare - Bothell, WA

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 toward d...

Case Manager (Field Based in Skagit County, WA)

Molina Healthcare - Bothell, WA

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 Analyst, Healthcare Analytics

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryPerforms research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.Knowledge/Skills/Abilities...

Director, Health Plan Quality Interventions

Molina Healthcare - Bothell, WA

Job DescriptionJob Summary The Director, Health Plan Quality Interventions is responsible for implementing quality improvement interventions and acting as the subject matter expert for the health plan. Key activities include implementing, monitoring and analyzing the effectiveness of a comprehensive intervention strategy and facilitating stakeholder input ...

RN SIU Investigator - WA

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryThe Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing revi...

RN Case Manager, Disease Management (Remote in Washington)

Molina Healthcare - Bothell, WA

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 ...

Specialist, Community Engagmnt

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryResponsible for achieving established goals improving Molina's enrollment growth objectives encompassing all lines of business. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages.Knowledge/Skills/Abilities• Under limited supervision, re...

Sr Specialist, Community Engagement

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryResponsible for achieving established goals improving Molina's enrollment growth objectives encompassing all lines of business. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages.Knowledge/Skills/Abilities• Under limited supervision, re...

Provider Contracting Manager

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryNegotiates agreements with highly visible providers who are strategic to the success of the Plan, including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers.Knowledge/Skills/Abilities• In conjunction with Director/Manager Provide...

Claims, Provider Inquiry Research and Resolution

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryMolina Health Plan Operations jobs are responsible for the development and administration of our State health plan's operational departments, programs and services, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.

Supervisor, Provider Configuration Management - Healthcare

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryResponsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to...

Care Connections Representative (Customer Service)

Molina Healthcare - Bothell, WA

Job DescriptionJob Summary• Accurately record all calls in QNXT or other systems as applicable • Responds to internal and external customers in a timely and accurate manner, treating them with respect and courtesy• Advise callers of outstanding HEDIS services needed• Assists callers with Web Portal registration and utilization• Ad hoc r...

Pharmacy Technician

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryMolina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with a...

Pharmacy Technician

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryMolina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with a...

Sr. Abstractor, HEDIS/Quality Improvement

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryMolina's Quality Improvement Sr. Abstraction team functions to conduct data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The abstraction team will meet chart abstraction productivity standards as well as minimum over read standards.Knowledge/...