Jobs at Molina Healthcare in Columbus, OH

23 job openings within 25 miles

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Senior 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/Abili...

Bilingual Contact Center Associate Rep

Molina Healthcare - Columbus, OH

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 Processor

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 ...

Senior Medical Director, Health Plan

Molina Healthcare - Columbus, OH

Job SummaryBring your physician leadership, UM and Medical Director experience and commitment to quality to our Ohio health plan. You will provide guidance to staff, be responsible for day-to-day operations of the Medical Affairs department, and represent the plan at state regulatory agency meetings.Responsibilities: • Assists in recruitment, hiring an...

Case Manager (RN)

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 ...

Specialist, Appeals & Grievances

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryResponsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is 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 an...

Care Review Clinician, Inpatient Review (RN)

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...

Bilingual, Member Services Rep (Call /Contact Center )

Molina Healthcare - Columbus, OH

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...

Analyst, Business

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryAnalyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creat...

Analyst, Provider Configuratio

Molina Healthcare - Columbus, OH

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 ...

Analyst, Provider Configuratio

Molina Healthcare - Columbus, OH

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 ...

Analyst, Provider Configuratio

Molina Healthcare - Columbus, OH

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 ...

Assoc Analyst, Provider Configuration

Molina Healthcare - Columbus, OH

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 ...

RN Case Manager, LTSS Dayton/Cincinnati

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 ...

Case Manager, LTSS

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 ...