Jobs at Molina Healthcare in Long Beach, CA - Page 4

86 job openings within 25 miles

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Adjuster, Claims Medicare and Healthcare

Molina Healthcare - Long Beach, CA

Claims Adjustments - knowledge of healthcare and managed care claims processes, review, correction. Medicare knowledge and experience a plus Job SummaryResponsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog ...

Director, Provider Contracts

Molina Healthcare - Long Beach, CA

Summary Bring your Medical & Medicare contracting management experience to our California health plan. Lead the contracting group handling LA, Orange County & Inland Empire areas. What you will do:Plan, organize, staff, and coordinate the Provider Contracts activities for the state health plan. Work with direct management, senior leadership/management, Cor...

Director, Provider Services

Molina Healthcare - Long Beach, CA

Job SummaryBring your strong provider relationship development and provider training & education to this leadership role within our California health plan. What you will do:• Provide and develop standards and resources to help the Molina health plan successfully develop and refine cost effective and high quality strategic provider networks, establishing b...

Director, Compliance

Molina Healthcare - Long Beach, CA

Job SummaryBring your compliance management experience and managed care regulatory knowledge to our California health plan to lead the compliance program and help prevent and/or detect violation of applicable laws and regulations. You will ensure the health plan's accountability for compliance by overseeing and resolving investigations. What you will do:

Sr Project Manager, PMO

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryFocuses on process improvement, organizational change management, project management and other processes relative to the business. Project management includes estimating, scheduling, costing, planning and issue/risk management.Knowledge/Skills/Abilities• Deep understanding of effective project approach(es) ...

Analyst, Business

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryAnalyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Crea...

RN Care Review Clinician, Inpatient Review - Remote -12 hour NOC

Molina Healthcare - Long Beach, CA

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...

RN Care Review Clinician, Inpatient Review

Molina Healthcare - Long Beach, CA

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...

RN Care Review Clinician, Inpatient Review - Medicare - Remote

Molina Healthcare - Long Beach, CA

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...

RN Care Review Clinician, Inpatient Review

Molina Healthcare - Long Beach, CA

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...

RN Care Review Clinician, Inpatient Review - SNF Team - Remote

Molina Healthcare - Long Beach, CA

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...

Community Connector(Jacksonville)

Molina Healthcare - Long Beach, CA

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, Enrollment Services (Healthcare)

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, employer's monthly reports, sending membership cards and materials. Verify enrollment status, make changes to records, research and resolve enrollment system rejections....

Financial Reporting Analyst

Molina Healthcare - Long Beach, CA

Molina Healthcare was founded in 1980 as a single community clinic in Long Beach, California. The goal was to create a future where everyone receives quality healthcare, and it is because of the dedication of our employees that we have been able to further this mission. Today, Molina Healthcare is a Fortune 300 company and has grown to over 20 states and territories, servicing nearly five milli...

Auditor, Quality

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryPerforms auditing activities in the Medicaid environment to ensure work is performed in accordance with internal and client expectations. Provides operational quality assurance and testing activities. Works with cross functional teams to identify and implement business process improvement opportunities. Monitors quality assur...