Jobs at Molina Healthcare in Doral, FL

20 job openings within 25 miles

Save This Search

Refine Your Search

Show more Show less
Displaying results 1 - 15 of 20

Specialist, HEDIS/ Quality Reporting

Molina Healthcare - Doral, FL

Job Description Job Summary Molina'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 measurement activities...

Analyst, Data-Healthcare

Molina Healthcare - Doral, FL

Job Description Job Summary Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data fr...

Regional Contact Center Director

Molina Healthcare - Doral, FL

Job Description Job Summary Provides 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 relationships. R...

Supervisor, Member Services (MarketPlace)

Molina Healthcare - Doral, FL

Job Description Job Summary Provides 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 relationships. R...

Supv, Appeals & Grievances

Molina Healthcare - Doral, FL

Job Description Job Summary Responsible 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 and Medicaid

Sr Account Rep, Medicare

Molina Healthcare - Doral, FL

Job Description Job Summary Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within approved market areas to achieve stated revenue, profitability and retention goals, while following ethical sales practices and adhering to established policies and procedures.

Dir, Compliance

Molina Healthcare - Doral, FL

Job Description Job Summary Establish 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 Health Care...

Analyst, Healthcare Analytics

Molina Healthcare - Doral, FL

Job Description Job Summary Performs 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/Abilities ...

Transition of Care Coach (RN)

Molina Healthcare - Doral, FL

Job Description Job Summary Molina 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 (RN)

Molina Healthcare - Doral, FL

Job Description Job Summary Molina 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 (RN)

Molina Healthcare - Doral, FL

Job Description Job Summary Molina 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...

Analyst, Healthcare Analytics

Molina Healthcare - Doral, FL

Job Description Job Summary Performs 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/Abilities ...

VP, Network Mgmt & Ops

Molina Healthcare - Doral, FL

Job Description Job Summary Molina Health Plan Operational Leadership roles provide overall direction and administration of the Plan's operational departments, programs and services. Responsibilities include: implementing programs that are in alignment with Molina Healthcare's strategic and operating plan; providing day-to-day leadership and management of th...

Specialist, Community Engagement

Molina Healthcare - Doral, FL

Job Description Job Summary Responsible for achieving established goals improving Molina's enrollment growth objectives encompassing all lines of business. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages. Knowledge/Skills/Abilities • Under limited supervision, responsible fo...

Mgr, Provider Inquiry R&R

Molina Healthcare - Doral, FL

Job Description Job Summary Molina 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...