Jobs at Molina Healthcare - Page 11

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RN Care Review Clinician, Inpatient Review

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...

RN Care Review Clinician, Inpatient Review - Remote -12 hour NOC

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...

Sr Account Rep, Medicare

Molina Healthcare - Irving, TX

Job DescriptionJob SummaryResponsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within approved market areas to achieve stated revenue, profitability and retention goals, while following ethical sales practices and adhering to established policies and procedur...

RN, Care Review Clinician, Utilization Management Inpatient Review

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...

Director, Government Contracts and Advocacy

Molina Healthcare - Irving, TX

Job DescriptionJob SummaryResponsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations.Knowledge/Skills/Abilities• Responsible ...

RN Care Review Supervisor - Inpatient Review (UM)

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 d...

National Director, Interventions

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryThe National Director, Quality Interventions is responsible for setting the strategic direction and overseeing the implementation of effective quality improvement intervention strategies for Molina. Key activities include developing, implementing and monitoring a comprehensive intervention strategy that encompasses multi-funct...

Operational Excellence Process Consultant

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryLeads business process improvement initiatives that result in operational efficiencies and/or an increase in customer satisfaction. Assists in development of Molina Healthcare of Washington business process improvement and in the implementation of a business process improvement capability utilizing Lean methodology....

Sr Rep, Enrollment Services - Managed Care

Molina Healthcare - San Antonio, TX

Strong ability to use MS Excel of reviewing created spreadsheets, sorting, finding, filtering, extracting data.Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, employer's monthly reports, sending membership cards and materials. Verify enrollment status, make changes to reco...

Care Review Clinician, Inpatient Review (RN)

Molina Healthcare - Columbus, 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...

HR Business Partner

Molina Healthcare - Doral, FL

Job DescriptionJob SummaryResponsible for building relationships with employees at all levels of the organization while supporting their Human Resources (HR) needs. Performs HR related duties in some or all of the following functional areas: employment & talent acquisition, employee relations, new employee orientation & training, workplace compliance, ...

Provider Contracts Manager Behavioral Health

Molina Healthcare - Bothell, WA

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...

Director, Provider Services

Molina Healthcare - Long Beach, CA

Job SummaryBring your strong provider relationship development and provider training & education to this leadership role within our California health plan. What you will do:• Provide and develop standards and resources to help the Molina health plan successfully develop and refine cost effective and high quality strategic provider networks, establishing b...

Director, Provider Contracts

Molina Healthcare - Long Beach, CA

Summary Bring your Medical & Medicare contracting management experience to our California health plan. Lead the contracting group handling LA, Orange County & Inland Empire areas. What you will do:Plan, organize, staff, and coordinate the Provider Contracts activities for the state health plan. Work with direct management, senior leadership/management, Cor...

Medical Director, Health Plan

Molina Healthcare - Oak Brook, IL

Job Summary Bring your physician leadership and utilization review/management experience to our Medical Director role in the Illinois health plan. Solid performance in UM/UR arena may lead to project work in population health and affecting health outcomes for tens of thousands of members. What you will do:Provide medical oversight and expertise in ...