Jobs at Molina Healthcare in Columbus, OH

23 job openings within 25 miles

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Project Coordinator-Quality Intervention Team

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryProvides general administrative support that includes routine document preparation, file management, scheduling/arranging meetings, arranging travel and ordering office supplies. May also perform a variety of activities in support of the functional processes, programs and/or services. Also provides the administration of various programs, ...

Manager, Healthcare Analytics

Molina Healthcare - Columbus, OH

Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise, manages relationships with operational leaders and staff. Directs staff assigned to their projects, maintains internal work plans as well as project work plans to meet reporting needs of the Health Plan. Resource to HCS staff for mentoring, coaching, and analysis questi...

Lead Analyst, Finance

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryResponsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and similar financial projects or programs. Duties include gathering, interpreting, and evaluating financial information; generating forecasts and analy...

Sr Analyst, Healthcare Analytics - Columbus, OH

Molina Healthcare - Columbus, OH

Performs 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.SQL knowledge and daily working with developing ad-hoc repo...

Healthcare Actuarial Analyst - Columbus, OH

Molina Healthcare - Columbus, OH

Responsible for estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks.Knowledge/Skills/Abilities• Collaborate with Actuarial staff to perform IBNR estimates and rate adequacy studies. Document assumptions. • Analyze results to identify early signs of trends...

Analyst, Healthcare Analytics

Molina Healthcare - Columbus, OH

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...

Member Appeals Nurse (LPN)

Molina Healthcare - Columbus, OH

Job DescriptionThis role requires you to be a passionate advocate for our members. You will assist them in getting their claims paid appropriately and timely with compassion. This role is for an LPN in the State of Ohio. Job SummaryResponsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage a...

Care Review Processor-Care Review

Molina Healthcare - Columbus, OH

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 desir...

Case Manager Social Worker

Molina Healthcare - Columbus, OH

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 desir...

Care Review Processor Medicaid BH Team

Molina Healthcare - Columbus, OH

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 desir...

Case Manager (RN) Medicaid

Molina Healthcare - Columbus, OH

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 desir...

Peer Specialist

Molina Healthcare - Columbus, OH

Job Description We are so excited to be able to offer this role as part of a larger Behavioral Health Initiative. This role is a vital life line for those who are suffering a variety of concerns including Mental Health and or Alcohol/Chemical Dependency. In the State of Ohio this role requires someone who has lived with these issues and has been in recover for at least two years...

Specialist, Delegation Oversight

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryResponsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance primarily with DMHC and DHCS requirements including delegation standards and requirements contained in the Molina Medical Compliance and Fraud, Waste and Abuse Program.Knowledge/Skills/A...

Assoc Rep, Provider Inquiry R&R

Molina Healthcare - Columbus, OH

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.Provide...

Supv, HCS Operations Support

Molina Healthcare - Columbus, OH

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 desir...