Jobs at Molina Healthcare in Doral, FL

8 job openings within 25 miles

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RN Case Manager - (2) years of Pediatrics Experience

Molina Healthcare - Doral, FL

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, Quality Interventions/ QI Compliance

Molina Healthcare - Doral, FL

Job DescriptionJob SummaryMolina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measuremen...

Sr Specialist, Provider Contracts

Molina Healthcare - Doral, FL

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 ...

Manager, Provider Contracts

Molina Healthcare - Doral, FL

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, LVN, MSW - Case Manager

Molina Healthcare - Doral, FL

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 ...

Actuarial Analyst

Molina Healthcare - Doral, FL

Job DescriptionJob SummaryResponsible 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.

RN SIU Investigator - (Miami, FL)

Molina Healthcare - Doral, FL

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...

RN Case Manager

Molina Healthcare - Doral, FL

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 ...