Jobs at Molina Healthcare - Page 12

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Displaying results 166 - 180 of 453

Community Connector (Field Base)

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...

AVP, Quality Improvement

Molina Healthcare - North Charleston, SC

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...

Senior Specialist, Quality Interventions/QI Compliance

Molina Healthcare - North Charleston, SC

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...

Specialist, Quality Interventions/QI Compliance

Molina Healthcare - North Charleston, SC

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 - Long Beach, CA

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...

Lead Engineer, Applications

Molina Healthcare - Long Beach, CA

Job Description Job Summary Designs and builds company specific enterprise application systems and technology expertise across multiple disciplines. Applies and promotes key principles (e.g. stability, scalability, performance, security, compatibility, re-use), helping ensure a balance between tactical and strategic technology solutions. Considers business proble...

Sr Engineer, Applications

Molina Healthcare - Long Beach, CA

Job Description Job Summary Designs, develops, and communicates technology models and foundations used to run applications, data, and infrastructure in support of one or more business processes. Applies and promotes key principles (e.g. stability, scalability, performance, security, compatibility, re-use), helping ensure a balance between tactical and strategic tech...

Community Connector (Chesterfield, Marlboro, Darlington Florence or Marion county)

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...

Supervisor, Healthcare Services

Molina Healthcare - San Antonio, TX

Job Description Job Summary Works with physicians and multidisciplinary team members to develop a plan of care for each assigned patient from admission through discharge. Assesses members for care needs, and develops treatment plan with practitioners, providers, members and support system. Ensures quality member care is provided. Ensures patient is progressing towar...

Regional CFO - Illinois and Wisconsin

Molina Healthcare - Oak Brook, IL

Knowledge/Skills/Abilities • Premium Revenue – coordinate efforts across region with similar lines of businesses to ensure consistent processes for managing premium revenue including MLTSS revenue management and appropriate risk adjustment. Review and analyze premium rates within the region for appropriateness. Develop analysis and arguments to support rate negotiations with the s...

Regional CFO - Washington, Utah, Idaho

Molina Healthcare - Bothell, WA

Knowledge/Skills/Abilities • Premium Revenue – coordinate efforts across region with similar lines of businesses to ensure consistent processes for managing premium revenue including MLTSS revenue management and appropriate risk adjustment. Review and analyze premium rates within the region for appropriateness. Develop analysis and arguments to support rate negotiations with the s...

Regional CFO - Michigan

Molina Healthcare - Troy, MI

Knowledge/Skills/Abilities • Premium Revenue – coordinate efforts across region with similar lines of businesses to ensure consistent processes for managing premium revenue including MLTSS revenue management and appropriate risk adjustment. Review and analyze premium rates within the region for appropriateness. Develop analysis and arguments to support rate negotiations with the s...

Sr Adjuster, Healthcare Claims

Molina Healthcare - Long Beach, CA

Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards. Knowledge/Skills/Abilities • Leads overall performance accountab...

Provider Dispute & Appeals Resolution Specialist (7).

Molina Healthcare - Columbus, OH

Job Description The ideal candidate would have experience in: - Claims examining, processing or adjudication - Health insurance background - Coding experience: CPT, ICD-9, ICD-10, DRG Job Summary Molina Health Plan Operations jobs are responsible for the development and administration of our State health plan's operationa...

Licensed Social Worker/Field Case Manager - Pierce County

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...