Jobs at Molina Healthcare in Columbus, OH - Page 2

27 job openings within 25 miles

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Certified Pharmacy Technician

Molina Healthcare - Columbus, OH

Job DescriptionThis is an exciting time to join our PBM (Pharmacy Benefit Program). The Ohio Plan has approximately 327,000 members who need your guidance as they navigate the very complex world of pharmaceutical care. You would be a part of a Regional Team that ensures that our members receive accurate, timely and cost effective medications. Come join this vital team as they gr...

Certirfied Pharmacy Technician

Molina Healthcare - Columbus, OH

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 all federal a...

Specialist, Appeals & Grievances Provider Research & Resolution

Molina Healthcare - Columbus, OH

Ohio Plan Specific: Duties and Responsibilities (List all essential duties and responsibilities in order of importance) · Research and document denial determinations at all levels of reconsiderations/appeals in a thorough, professional and expedient manner. · Coordinate workflow between departments and interface with internal and external resources. Formulate...

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...

Provider Rep-Claims Research & 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.Provide...

Assoc Rep, Provider Inquiry Research & 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.Provide...

Healthcare Quality Analytics Manager

Molina Healthcare - Columbus, OH

Job DescriptionJob Summary In collaboration with the Director, AVP and/or VP, the Healthcare Quality Analytics Manager will develop and provide reports and cost-benefit analysis tools to meet Quality Improvement requirements and oversees the use of automated software tools and processes to help streamline activities and improve data/analytics for the quality team.

Operational Excellence Process Improvement Business Analyst, Lean Six Sigma

Molina Healthcare - Columbus, OH

Job Description Job Qualifications Ohio 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 ...

Supervisor - Utilization Review (RN) E

Molina Healthcare - Columbus, OH

Job DescriptionOhio Plan Specific: This role is part of our Utilization Management team. You would be supervising a team of Seasoned Nurses who are responsible for the Prior Authorization and evaluation of medical needs for our members. This role would be great for an experienced Nurse from the Medical Surg background. Job SummaryMolina Healthcare Ser...

Care Review Processor-UM Operations

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-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...