Jobs at Molina Healthcare - Page 10

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Director, Health Plan Quality Interventions

Molina Healthcare - Irving, TX

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...

Mgr, Healthcare Services – NICU/High Risk OB

Molina Healthcare - Bothell, WA

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 - Columbus, OH

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...

Field Case Manager (SUD) - Spokane

Molina Healthcare - Spokane, WA

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. Abstractor, HEDIS/Quality Improvement

Molina Healthcare - Troy, MI

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...

Analyst, Finance

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and similar financial projects or programs. Duties include gathering, interpreting, and evaluating financial information; generating forecasts and analy...

Specialist, Appeals & Grievanc

Molina Healthcare - Oak Brook, IL

Job Description Job Summary Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member complaints and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid

Supv, Quality Interventions/QI Compliance - PQOC - RN

Molina Healthcare - Spokane, WA

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 - Troy, MI

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...

Dir, Health Plan Quality Improvement

Molina Healthcare - Troy, MI

Job Description Job Summary Serves as a leader of health plan Quality strategy and activities, including but not limited to leadership and primary Molina interface with state agencies, leadership of local Quality committees and oversight of intervention activities intended to improve quality measures and outcomes, The Quality Director will collaborate with MHI Quali...

Lead, Provider Inquiry R&R

Molina Healthcare - Long Beach, CA

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 Connections Rep

Molina Healthcare - Bothell, WA

Job Description Job Summary • Accurately record all calls in QNXT or other systems as applicable • Responds to internal and external customers in a timely and accurate manner, treating them with respect and courtesy • Ad hoc requests for member materials Knowledge/Skills/Abilities • Respond to incoming calls from members and providers. • M...

Auditor, Appeals & Grievances

Molina Healthcare - Long Beach, CA

Job Description Job Summary Molina Healthcare's Appeals & Grievances jobs are responsible for reviewing and resolving member complaints and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid. Knowledge/Skills/Abilities • Conducts aud...

Program Manager

Molina Healthcare - Troy, MI

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 ...

Care Review Clinician, Prior Authorization

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...