Jobs At Molina Healthcare In Louisville, KY | CareerArc

Jobs at Molina Healthcare in Louisville, KY

60 job openings within 25 miles

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Analyst, Healthcare Analytics

Molina Healthcare - Louisville, KY

Job Description Job Summary Performs research and analysis of complexhealthcare claims data, pharmacy data, and lab data regarding networkutilization and cost containment information. Evaluates, writes, and presentshealthcare utilization and cost containment reports and makes recommendationsbased on relevant findings. Knowledge/Skills/Abilities • Develop ad-hoc rep...

Assoc Analyst, Provider Config

Molina Healthcare - Louisville, KY

Job Description Job Summary Responsible 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...

Provider Contracts Manager-Remote(Kentucky)

Molina Healthcare - Louisville, KY

Job Description Job Summary Negotiates agreements with highly visible providers who are strategic to the success of the Plan, including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers. Knowledge/Skills/Abilities • In conjunction with Director/Manager Provider Contracts,...

Mgr, Healthcare Services (Remote)

Molina Healthcare - Louisville, KY

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...

Sr Rep, Medicare Provider Services - Remote/Field - Louisville, Kentucky

Molina Healthcare - Louisville, KY

Job Description Job Summary Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Services...

Sr Specialist, Govt Contracts

Molina Healthcare - Louisville, KY

Job Description Job Summary Responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations. Knowledge/Skills/Abilities • Responsible for coordina...

Sr Specialist, HEDIS Quality Interventions - Louisville

Molina Healthcare - Louisville, KY

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...

Sr Analyst, HEDIS/Quality Reporting

Molina Healthcare - Louisville, KY

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...

Director, Government Contracts

Molina Healthcare - Louisville, KY

Job Description Job Summary Responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations. Knowledge/Skills/Abilities • Responsible for managing...

Case Management Processor

Molina Healthcare - Louisville, KY

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...

Transition of Care Coach (RN)

Molina Healthcare - Louisville, KY

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...

Sr. Analyst, Healthcare Analytics

Molina Healthcare - Louisville, KY

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 ...

Case Manager (RN)

Molina Healthcare - Louisville, KY

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...

Mgr, Provider Inquiry R&R

Molina Healthcare - Louisville, KY

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...

Care Review Clinician, Inpatient Review (RN)

Molina Healthcare - Louisville, KY

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...