Jobs at Molina Healthcare in Columbus, OH

15 job openings within 25 miles

Save This Search

Refine Your Search

Show more Show less
Displaying all 15 results

Specialist, Provider Contracts

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 ...

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 ...

Financial 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...

Sr 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 forecas...

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 ...

Assoc Rep, Provider Inquiry Research and Resolution

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.

Case Manager (RN) Field Nursing Facility Cincinnati Area

Molina Healthcare - Columbus, OH

Job DescriptionOhio Plan Specific: Molina Healthcare of Ohio State Plan requires that this role be covered by a Registered Nurse. The purpose of the role is to visit the Molina Member in the Nursing Facility and sometimes the homes to facilitate Case Management for them. This is a field position in Cincinnati area. Although it is meant to be remote in nature, the first s...

Senior Managed Care Quality 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...

Sr. Healthcare Analyst (Medicaid Encounters)

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...

Sr. Healthcare Process Improvement Analyst

Molina Healthcare - Columbus, OH

Job DescriptionOhio Plan Specific: This role is part of the Operational Excellence team, which leads continuous improvement activities within Molina Healthcare's Ohio Plan. Healthcare Services is the largest division of the Ohio Plan, which has a total of over 1100 employees. This role would focus on small-to-medium scale process improvement projects...

Director, Government Contracts

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryResponsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations.Knowledge/Skills/Abilities• Responsible ...

Medical Director, Behavioral Health - Psychiatrist

Molina Healthcare - Columbus, OH

Job Summary Bring your clinical psychiatric experience and desire to affect behavioral health on a large scale to our health plan in Ohio. If you have experience in utilization review and specialty in substance use disorders, all the better. The BH team provides leadership and guidance for utilization management and case management programs for mental health and chemical...

Delegation Oversight Nurse (LPN)

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryResponsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance primarily with NCQA, CMS and State Medicaid requirements including delegation standards and requirements contained in the delegation agreement.Knowledge/Skills/Abilities

Registered Nurse Transition of Care Coach

Molina Healthcare - Columbus, OH

Job DescriptionOhio Plan Specifics: The Ohio Plan requires this role to be occupied by a Registered NurseJob 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 ca...

Supervisor, Provider Inquiry Research and Resolution

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryProvider Inquiry/Services staff are responsible for the submission, research, and resolution of provider inquiries and/or disputes. They respond with the answer to all incoming inquiries and coordinate with other Molina departments as needed to resolve the issue, as well as to correct the underlying cause, ensuring that resolu...