Jobs at Molina Healthcare - Page 16

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Care Review Processor

Molina Healthcare - El Paso, TX

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...

Case Manager

Molina Healthcare - El Paso, TX

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...

Care Review Clinician, Inpatient Review (RN) - Remote

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...

Provider Network Manager-South Region

Molina Healthcare - San Juan, Puerto Rico

Job Description Job Summary Molina 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. Provider Network ...

Provider Network Manager-Institutional

Molina Healthcare - San Juan, Puerto Rico

Job Description Job Summary Molina 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. Provider Network ...

Provider Network Manager

Molina Healthcare - San Juan, Puerto Rico

Job Description Job Summary Molina 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. Provider Network ...

Provider Network Manager

Molina Healthcare - San Juan, Puerto Rico

Job Description Job Summary Molina 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. Provider Network ...

Assoc Rep, Provider InquiryR&R

Molina Healthcare - Bothell, WA

Job Description Job Summary Molina 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. Provide...

Sr Analyst, Healthcare Analytics

Molina Healthcare - Long Beach, CA

Job Description Job Summary Work on Molina's enterprise analytics projects in an agile environment where you're leveraging your relationship management skills to understand the customer's needs to build dashboards/tools. Our focus is to enable our customers to better understand their business, make data driven decisions, and become more efficient.

Sr Analyst, Healthcare Analytics

Molina Healthcare - Long Beach, CA

Job Description Job Summary Work on Molina's enterprise analytics projects in an agile environment where you're leveraging your relationship management skills to understand the customer's needs to build dashboards/tools. Our focus is to enable our customers to better understand their business, make data driven decisions, and become more efficient.

Assoc Actuarial Analyst

Molina Healthcare - Fairfax, VA

Job Description Job Summary Responsible for estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. Knowledge/Skills/Abilities • Support the development of the IBNR estimates and rate adequacy studies. Document assumptions. • Analyze re...

Mgr, Actuarial Svcs

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. Knowledge/Skills/Abilities • Perform IBNR estimates and rate adequacy studies. Document assumptions. Oversee the creation of actuarial opini...

Specialist, Appeals & Grievances

Molina Healthcare - Irving, TX

Job Description Job Summary Responsible 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

Project Coordinator

Molina Healthcare - Irving, TX

Job Description Job Summary Provides general administrative support that includes routine document preparation, file management, scheduling/arranging meetings, arranging travel and ordering office supplies. May also perform a variety of activities in support of the functional processes, programs and/or services. Also provides the administration of various programs, ...

Dir, Health Plan Quality Improvement

Molina Healthcare - Long Beach, CA

Job Description Job Summary Serves as a leader of health plan Quality strategy and activities, including but not limited to leadership and primary Molina interface with state agencies, leadership of local Quality committees and oversight of intervention activities intended to improve quality measures and outcomes, The Quality Director will collaborate with MHI Quali...