Jobs at Molina Healthcare

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Claims, Dispute and Appeals Specialist (Provider Inquiry R&R)

Molina Healthcare - Bothell, WA

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...

Member Health Assessor, LVN

Molina Healthcare - Long Beach, CA

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 - Bilingual in Spanish (Long Beach, CA)

Molina Healthcare - Long Beach, CA

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, LTSS RN or LSW

Molina Healthcare - Columbus, OH

Job Description Please be aware that the State of Ohio Contract requires this role to be filled by either an RN or a Licensed Social Worker. We cannot hire an LPN for this role. 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...

Correspondence Processor

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...

Care Review Processor

Molina Healthcare - Irving, TX

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...

Specialist, Delegation Oversight

Molina Healthcare - Oak Brook, IL

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...

Assoc Specialist, Member Engagement

Molina Healthcare - Syracuse, NY

Job Description Job Summary Responsible for continuous quality improvements regarding member engagement and member retention. Represents Member issues in areas involving member impact and engagement including: Appeals and Grievances, Member Problem Research and Resolution, and the development/maintenance of Member Materials. Knowledge/Skills/Abilities

Bilingual Call Center Reps (Multiple Openings)

Molina Healthcare - Irving, TX

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...

Mgr, Healthcare Services

Molina Healthcare - Syracuse, NY

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/Care Coordinator (RN)-Midlands/Columbia

Molina Healthcare - North Charleston, SC

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, LTSS (RN or Licensed Social Worker)

Molina Healthcare - Troy, MI

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...

Supervisor, Accounting

Molina Healthcare - Irving, TX

Job Description Job Summary Use of general accounting principles and rules to create financial reports and analysis. Duties include all aspects of the Accounting function, such as, control of accounts and records, recording of transactions, analysis of financial data, preparation budgets, forecasts, financial statements and accounting schedules/reports, and auditing...

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...

Pharmacy Technician

Molina Healthcare - Irving, TX

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...