Jobs at Molina Healthcare - Page 10

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Specialist, Appeals & Grievanc

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible 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...

Assoc Rep, Provider InquiryR&R

Molina Healthcare - Troy, MI

Job Description Job 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....

Sr Specialist, Appeals & Grievances (Nurse RN or LPN)

Molina Healthcare - Troy, MI

Job DescriptionJob SummaryResponsible 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...

Case Manager (RN) Community Well, MMP Duals

Molina Healthcare - Cincinnati, OH

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 ...

Provider Contracts Manager

Molina Healthcare - Flint, MI

Job Description Job SummaryNegotiates agreements with highly visible providers who are strategic to the success of the Plan, including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers.Knowledge/Skills/Abilities• In conjunction with Director/Manager Provider...

Provider Services Rep

Molina Healthcare - Flint, MI

Job Description Job 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. Provid...

Sr Rep, Provider Services

Molina Healthcare - Grand Rapids, MI

Job Description Job 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. Pr...

Sr Specialist, Member Engagement (Field)

Molina Healthcare - Milwaukee, WI

Job Description Job SummaryResponsible 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...

Clerk

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryProvides general administrative support that includes routine document preparation, file management, scheduling/arranging meetings, arranging travel and ordering office supplies. May also perform a variety of activities in support of the functional processes, programs and/or services. Also provides the administration of variou...

Director, Medicare Pharmacy Services

Molina Healthcare - Midvale, UT

Job DescriptionJob SummaryMolina 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 ...

Case Manager (RN) Field Nursing Facility Cincinnati Area

Molina Healthcare - Columbus, OH

Job DescriptionOhio Plan Specific: Molina Healthcare of Ohio State Plan requires that this role be covered by a Registered Nurse. The purpose of the role is to visit the Molina Member in the Nursing Facility and sometimes the homes to facilitate Case Management for them. This is a field position in Cincinnati area. Although it is meant to be remote in nature, the first s...

Specialist, Community Engagmnt

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryResponsible for achieving established goals improving Molina's enrollment growth objectives encompassing all lines of business. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages.Knowledge/Skills/Abilities• Under limited supervision, re...

Sr Specialist, Community Engagement

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryResponsible for achieving established goals improving Molina's enrollment growth objectives encompassing all lines of business. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages.Knowledge/Skills/Abilities• Under limited supervision, re...

LPN/CHW/LISW Community Connector Dayton Area

Molina Healthcare - Cincinnati, OH

Job DescriptionOhio Plan Specific. This role will be the outreach to members in Dayton Ohio. This is a perfect role for someone who likes to personally connect with members. It is a very community outreach based role. Job SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan...

Senior Managed Care Quality Analyst, Healthcare Analytics

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryPerforms 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.Knowledge/Skills/Abili...