Jobs at Molina Healthcare in Midvale, UT

23 job openings within 25 miles

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Sr. Abstractor, HEDIS/Quality Improvement

Molina Healthcare - Midvale, UT

Job Description Job Summary Molina's Quality Improvement Sr. Abstraction team functions to conduct data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The abstraction team will meet chart abstraction productivity standards as well as minimum over read standards. Knowledge/Skills/Abili...

Registered Nurse: SIU Investigator - Utah

Molina Healthcare - Midvale, UT

Job Description Job Summary The 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...

Sr Specialist, Delegation Oversight

Molina Healthcare - Midvale, UT

Job Description Job Summary Responsible 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...

Broker Channel Mgr

Molina Healthcare - Midvale, UT

Job Description Job Summary Responsible for the development and maintenance of an effective and efficient broker channel for assigned geographical region. Work in collaboration with other Broker Channel Managers, Field Sales Managers, Directors, and AVPs as needed in assigned states. Develop a high functioning, high performing broker network which is strategically a...

Sr Account Rep, Medicare

Molina Healthcare - Midvale, UT

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.

Program Manager

Molina Healthcare - Midvale, UT

Job Description Job Summary Manages people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and ...

Senior Project Manager (Business Projects)

Molina Healthcare - Midvale, UT

Job Description Job Summary Manages people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and ...

Assoc Analyst, Provider Config

Molina Healthcare - Midvale, UT

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...

Specialist, Quality Interventions/QI Compliance

Molina Healthcare - Midvale, UT

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...

Specialist, HEDIS/ Quality Reporting

Molina Healthcare - Midvale, UT

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...

Medical Director, Health Plan

Molina Healthcare - Midvale, UT

Job Description Job Summary • Doctorate Degree in Medicine • Board Certified or eligible in a primary care specialty Knowledge/Skills/Abilities Provides medical oversight and expertise in appropriateness and medical necessity of healthcare services provided to Plan members, targeting improvements in efficiency and satisfaction for pat...

Rep, Pharmacy

Molina Healthcare - Midvale, UT

Job Description Job Summary Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal a...

Medical Director, Behavioral Health - Psychiatrist

Molina Healthcare - Midvale, UT

Job Summary Bring your clinical psychiatric experience, leadership & initiative to the Behavioral Health function of the Utah & Idaho health plans. The BH Medical Director will conduct utilization reviews, determine strategic direction of BH activities and develop recommendations for integrated mental health and chemical dependency programs and outreach statewide.

Pharmacy Technician, CPT or CPhT (UT or IL)

Molina Healthcare - Midvale, UT

Job Description Job Summary Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance wit...

VP, Healthcare Services

Molina Healthcare - Midvale, UT

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...