Jobs at Molina Healthcare - Page 10

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Displaying results 136 - 150 of 395

Rep, Provider Services (MMS)

Molina Healthcare - Augusta, ME

Job DescriptionJob SummaryResponsible for answering all calls from providers regarding claims issues, eligibility and benefits, and website assistance in a call center setting, and to satisfactorily resolve calls within expected response time standards. May also answer and resolve calls from members.Knowledge/Skills/Abilities• Handles heavy inbo...

Analyst, Dental

Molina Healthcare - Baton Rouge, LA

Job DescriptionJob SummaryInvestigates and resolves cases involving aberrant dental practices. Reviews claims using records and system reports to determine proper documentation, utilization and appropriateness of services and to identify possible fraud and abuse.Knowledge/Skills/Abilities• Performs post payment analysis of claims and records.

Rep, Provider Inquiry R&R

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryMolina 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...

Deputy Account Manager

Molina Healthcare - Trenton, NJ

Job DescriptionJob Summary• Primary areas of focus includes management and supervision over one or more of the functional departments of Molina Medicaid contract for providing fiscal agent and implementation services to the customer/state.• The Requirements of the role is to plan, coordinate and implement software systems to customer site. This includes utilizing resources...

Analyst, Medical Informatics

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryPerforms intermediate to complex level of technical and analytical work to support reporting and analysis needs for Medical Informatics and other customer functional areas. Expected to work with limited supervision. Integrate data from the various Molina Healthcare systems (QNXT, Medlnsight, etc.) to create actionable management reports t...

Analyst, Reporting & Analytics

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryCollects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing and deploying reports to provider networks and other end users for operational and strategic analysis.Knowledge/Skills/Abilities• Performs research and analyses on a variety ...

Sr. Project Controller - REMOTE East Coast

Molina Healthcare - Augusta, ME

Job DescriptionJOB SUMMARY: We are looking for an experienced Financial Controller to undertake all aspects of financial management representing Maine's Molina Medicaid Solutions site in Augusta, Maine. This key leadership position reports to the Director, Account Manager as a member of the senior leadership team. Molina Medicaid Solutions provides fu...

Care Review Processor

Molina Healthcare - Long Beach, CA

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...

Case Manager (RN)

Molina Healthcare - Bothell, WA

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...

Medical Claims: Senior Specialist, Delegation Oversight

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible 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...

Capacity Planner (Remote)

Molina Healthcare - Long Beach, CA

Knowledge/Skills/AbilitiesDevelop and deploy workforce management strategies nationwide. Partner with leaders by strategically identifying business needs, and propose solutions in line with the needs of our members and providers. Requires contact center experience with in-depth Workforce Management experience specializing in planning efforts. Ensures the right numbers of skilled ...

Scheduling Analyst

Molina Healthcare - Long Beach, CA

Knowledge/Skills/AbilitiesDevelop and deploy workforce management strategies nationwide. Partner with leaders by strategically identifying business needs, and propose solutions in line with the needs of our members and providers. Requires contact center experience with in-depth Workforce Management experience specializing in planning efforts. Ensures the right numbers of skilled ...

Analyst, Coding

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryEstablish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and regulations, which will protect the Business from liability of fraudulent or abusive practices. Ensures that the Business understands and complies with applicable laws and regulations pertaining to the Health Care...

Claims Representative, Call Center

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryProvides 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...

Member Services/Claims Rep, Call Center (Multiple Positions)

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryProvides 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...