Jobs at Molina Healthcare - Page 16

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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...

Medical Director, Behavioral Health - Psychiatrist

Molina Healthcare - Columbus, OH

Job Summary Bring your clinical psychiatric experience and desire to affect behavioral health on a large scale to our health plan in Ohio. If you have experience in utilization review and specialty in substance use disorders, all the better. The BH team provides leadership and guidance for utilization management and case management programs for mental health and chemical...

Health Manager, LVN (Bilingual in Spanish)

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible for working with members and providers to assess, facilitate, plan and coordinate the delivery of care across the continuum for members with potential risk for high cost and high utilization. Responsible for leading project initiatives aimed at reducing the cost of care and quality improvement. Oversees the develo...

Director, Health Plan Quality Interventions

Molina Healthcare - Bothell, WA

Job DescriptionJob Summary The Director, Health Plan Quality Interventions is responsible for implementing quality improvement interventions and acting as the subject matter expert for the health plan. Key activities include implementing, monitoring and analyzing the effectiveness of a comprehensive intervention strategy and facilitating stakeholder input ...

RN Supervisor, Care Review Prior Authorization

Molina Healthcare - Doral, FL

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 ...

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 unstruct...

Associate Rep, Provider Inquiry R&R

Molina Healthcare - Albuquerque, NM

Job DescriptionJob 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.

Case Manager (RN)

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...

Delegation Oversight Nurse (LPN)

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryResponsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance primarily with NCQA, CMS and State Medicaid requirements including delegation standards and requirements contained in the delegation agreement.Knowledge/Skills/Abilities

Information Security Compliance Analyst

Molina Healthcare - Long Beach, CA

Job Summary Responsible for ensuring Molina compliance with both regulatory and company Information Security policies. Conduct various types of Information Security compliance and risk assessments. Monitor compliance by internal business units with security standards and policies. Maintain an awareness of state, federal, and company-established Information Security regulation...

Analyst, Special Investigation Unit

Molina Healthcare - Long Beach, CA

Job Description Job 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 ...

Medical Director, Health Plan

Molina Healthcare - Long Beach, CA

Job Summary Bring your utilization review experience & physician leadership to our growing health plan. You will play an integral part in medical oversight to determine medical necessity of healthcare services provided to our members, targeting improvements in efficiency and satisfaction for patients and providers. You will also have the opportunity to educate and intera...

Supervisor, Care Management

Molina Healthcare - Edinburg, 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 ...

Examiner, Claims

Molina Healthcare - Boise, ID

Job DescriptionJob SummaryResponsible for administering claims payments, maintaining claim records. 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• Evaluates the adjudication of claims using standard pri...