Jobs at Molina Healthcare in Detroit, MI

18 job openings within 25 miles

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Chief Medical Officer, Health Plan

Molina Healthcare - Troy, MI

Knowledge/Skills/Abilities• Provides leadership to the health plan in the areas of strategic planning, strategy execution and implementation of care management programs, including such programs as Quality Improvement, Utilization Management, Care Management, Predictive Modeling, and Disease Management.• Leads the health plan's analysis of medical care cost and utilization dat...

Assoc Analyst, Provider Config

Molina Healthcare - Troy, MI

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 be housed on...

Program Manager, HCS (RN or MSW)

Molina Healthcare - Troy, MI

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...

Supv, Healthcare Services Care Transitions (Registerd Nurse or Licensed Social Worker

Molina Healthcare - Troy, MI

Job DescriptionJob SummaryWorks with physicians and multidisciplinary team members to develop a plan of care for each assigned patient from admission through discharge. Assesses members for care needs, and develops treatment plan with practitioners, providers, members and support system. Ensures quality member care is provided. Ensures patient is progressing towar...

Analyst, Coding

Molina Healthcare - Troy, MI

Job DescriptionJob SummaryEstablish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and regulations, which will protect the Business from liability of fraudulent or abusive practices. Ensures that the Business understands and complies with applicable laws and regulations pertaining to the...

Transition of Care Coach (RN)

Molina Healthcare - Troy, MI

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 ...

Director, Health Plan Long Term Svcs & Supports (LTSS)

Molina Healthcare - Troy, MI

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...

Mgr, Healthcare Services LTSS

Molina Healthcare - Troy, MI

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, LTSS (RN or Licensed Social Worker)

Molina Healthcare - Troy, MI

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...

Transition of Care Coach (RN)

Molina Healthcare - Troy, MI

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...

Registered Nurse: SIU Investigator - Michigan

Molina Healthcare - Troy, MI

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...

Mgr, Delegation Oversight

Molina Healthcare - Troy, MI

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...

Project Coordinator

Molina Healthcare - Troy, MI

Job DescriptionJob SummaryThe Project Coordinator will provide 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 administ...

VP, Healthcare Services

Molina Healthcare - Troy, MI

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...

Director Finance & Analytics

Molina Healthcare - Troy, MI

Director Finance & AnalyticsLocation: Troy, MichiganLeads the financial analysis of the health plan's performance. Lead and support financial and operational analysis for Medical Management and Provider Contracting. Review, evaluate and improve company business logic and data sources. Ensure timely creation of management reports. Ensure data integrity. Assist in developing,...