Jobs at Molina Healthcare - Page 14

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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...

Specialist, Health Plan Communications

Molina Healthcare - Milwaukee, WI

Job Description Job SummaryResponsible for the development of communications and marketing activities aimed at brand and message management. Develops, implements, and manages communications programs.Knowledge/Skills/Abilities• With minimal supervision, writes and develops content to support the creation of internal and external communi...

LSW Case Manager - Patient Visits - REMOTE

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...

Rep, Provider Services

Molina Healthcare - Albuquerque, NM

Job DescriptionJob 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. Provi...

Care Review Processor

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 ...

Case Manager -LTSS (Registered Nurse or Licensed Social Worker)

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 d...

VP, Encounters

Molina Healthcare - Long Beach, CA

Knowledge/Skills/AbilitiesThe Encounters Vice President oversees and monitors claims & encounters processes, including partnering with cross-functional teams (Plan or MHI) to prevent encounter rejections via root cause analysis and resolution. • Monitors and/or assigns encounter workflow queues; ensures volume and aging are current. • Oversees researching of claim...

VP, Core Operations

Molina Healthcare - Long Beach, CA

Knowledge/Skills/Abilities• Hires, coordinates training and manages staff involved in creating controls, documents and tools within the Corporate Claims, Shared Services, Corporate Ops PMO or Configuration Teams or other Corporate Operations areas reporting to the Core Ops Team in order to manage work in any of the assigned Corporate Operations areas for all lines of busi...

Transition of Care Coach (LSW)

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...

Director, Regulatory Affairs

Molina Healthcare - Columbus, OH

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 ...

Case Manager, Substance Use Disorder (Chelan, Douglas, Grant County)

Molina Healthcare - Spokane, 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 ...

Program Manager

Molina Healthcare - Long Beach, CA

Summary: The Enrollment Accounting File Management team currently handles all troubleshooting, Implementation and process improvements for the Operations enrollment team Enterprise wide. In order for us to meet the needs of the operations teams as well as support different LOB's and States. We need this Program Manager position filled to Meet the SLA's defined within Mo...

HR Business Partner Manager

Molina Healthcare - Doral, FL

Job DescriptionJob SummaryProvides strategic and operational HR consultation to assigned client groups, which may be located in multiple States. Responsible for the assessment of HR initiatives to support business strategies. Collaborates with Centers of Expertise (COEs) to develop and implement HR programs to meet business objectives. Provides compreh...

Director, Projects (Agile Project Management)

Molina Healthcare - Jackson, MS

Job DescriptionJob SummaryManages people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. Ma...

Case Manager

Molina Healthcare - Peoria, 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...