Jobs at Molina Healthcare in Syracuse, NY

18 job openings within 25 miles

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Sr Analyst, Healthcare Analytics

Molina Healthcare - Syracuse, NY

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.Experience in Medical Economics and Strong Knowledge of Performa...

Assoc Specialist, Provider Contracts

Molina Healthcare - Syracuse, NY

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 be housed on...

Field Case Manager-(BH) LMHC or Psychiatric Nurse

Molina Healthcare - Syracuse, NY

Job DescriptionNew York Plan Specific. The contract with the New York plans requires for this role to be have what is listed below. This role cannot be staffed with a Registered Nurse. Minimum of Associates Degree or Advanced Degree in Behavioral Health field, example a LMHC or LMSWThis license needs to be unrestricted license to practice ind...

Field Case Manager-(Behavioral Health) LMHC or Psychiatric RN

Molina Healthcare - Syracuse, NY

Job DescriptionNew York Plan Specific. The contract with the New York plans requires for this role to be have what is listed below. This role cannot be staffed with a Registered Nurse. Minimum of Associates Degree or Advanced Degree in Behavioral Health field, example a LMHC or LMSWThis license needs to be unrestricted license to practice ind...

RN Case Manager :Field Nurse: Syracuse area -New York

Molina Healthcare - Syracuse, NY

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 toward d...

Clinical Appeals Nurse (3+ Years of Hospital Acute Care Experience)

Molina Healthcare - Syracuse, NY

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 toward d...

Director, Health Plan Quality Improvement

Molina Healthcare - Syracuse, NY

Job DescriptionJob Summary The Director serves as the Quality Improvement leader for the State Health Plan and leads programs involving HEDIS, NCQA accreditation, risk scores for Medicare and Medicaid, CAHPS, and Performance Improvement Plans (PIP) for New York State. Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare...

Sr. Abstractor, HEDIS/Quality Improvement

Molina Healthcare - Syracuse, NY

Job DescriptionJob SummaryMolina'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. Our Ideal candidate will...

Manager, Quality Interventions

Molina Healthcare - Syracuse, NY

Job DescriptionJob SummaryThe Manager, Quality Interventions assists the Director and AVP in developing, implementing and monitoring the success of Molina national and/or plan-level Quality Improvement activities, including intervention projects, problem resolution and management of staff and contractors. The Manager is part of the Senior Leaders...

Peer Specialist

Molina Healthcare - Syracuse, NY

Job DescriptionJob SummaryMolina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical dependency services and assists with implementing integrated Behavioral Health care management programs.Knowledge/Skills/Abilities• Provides peer support services fo...

Medical Director - Part-Time (Healthplan)

Molina Healthcare - Syracuse, NY

Job SummaryBring your physician leadership experience to our growing healthplan and not only perform utilization reviews, but affect population health in New York state. You will serve as the primary liaison between administration and medical staff and assure the ongoing development and implementation of policies and procedures that guide and support the provision of medical sta...

Quality Associate Specialist

Molina Healthcare - Syracuse, NY

Job DescriptionJob Summary The Quality Associate Specialist, could be a contributor to one or more critical Quality functions. These functions include,but may not be limited to, Quality Reporting, Performance Measurement Operations, Interventions, Quality Improvement Compliance, and Quality Outreach. You will be responsible for planning, developing and directi...

Care Review Processor

Molina Healthcare - Syracuse, NY

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 toward desir...

Care Review Clinician, Inpatient Review (BH)

Molina Healthcare - Syracuse, NY

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 toward desir...

Provider Services Rep

Molina Healthcare - Syracuse, NY

Job DescriptionJob SummaryMolina 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. Provi...