Jobs at Molina Healthcare - Page 13

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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...

Assoc Rep, Member Services

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...

Sr Analyst, Data

Molina Healthcare - Irving, TX

Job DescriptionJob SummaryDesigns and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data fr...

Senior Business Analyst

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryAnalyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifica...

AVP, Healthcare Services Nursing Facility

Molina Healthcare - Irving, TX

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...

AVP, Healthcare Services LTSS

Molina Healthcare - Irving, TX

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...

Actuarial Analyst

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible for estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks.Knowledge/Skills/Abilities• Collaborate with Actuarial staff to perform IBNR estimates and rate adequacy studies. Document assumptions.

Transition of Care Coach (RN or Licensed Clinical Social Worker) Cook/ Collar Counties

Molina Healthcare - Oak Brook, IL

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...

Field Case Manager, LTSS

Molina Healthcare - Troy, MI

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...

Medicaid Case Manager (RN) Maternal Child Preference

Molina Healthcare - Independence, OH

Job DescriptionState of Ohio Plan requires a Registered Nurse for this role. We have expanded our services in the Independence office to reach out to Maternal Child members. Preference is given to those candidates with that background or open to that type of work. We would love to have someone who has a heart for the autistic child. We are changing lives, come join us. J...

Specialist, Appeals & Grievance

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 Medicaid

RN Case Manager - San Bernardino Office

Molina Healthcare - San Bernardino, 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...

Senior Actuarial Analyst, ASA

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible for estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks.Knowledge/Skills/Abilities• Collaborate with Actuarial staff to complete IBNR estimates and rate adequacy studies. Document assumptions. • ...

.NET Application Engineer

Molina Healthcare - Herndon, VA

Job DescriptionJob Summary:Models and applies .NET software engineering methods and techniques to the design, development, evaluation, integration, qualification and/or support of complex products, tools, or technologies in one or more areas of expertise.Knowledge/Skills/Abilities:• Designs, develops and deploys .NET/C# technical solutions to co...

Principal Engineer - Hadoop Admin (Remote)

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryBuilds company specific systems and technology expertise across multiple infrastructure and development disciplines including: Cloudera, CDH, Unix and Administrative support of Hadoop environments.Knowledge/Skills/Abilities• Extensive experience working with Cloudera deployments and CDH Administration. • We...