Jobs at Molina Healthcare - Page 17

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Bilingual Senior Advice Line Rep(Must be available weekends & holidays, hours:10:30pm to 6am)

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryAnswers calls from numerous clients ranging from the general community to physician practice clients, managed care members, and Home Care patients. Performs health assessments using computerized guidelines. Provides general health information using approved references. May provide physician referrals and community service referrals as nee...

Provider Services Representative, Los Angeles County

Molina Healthcare - Long Beach, CA

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. Provider Services...

Provider Network Manager

Molina Healthcare - Oak Brook, IL

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. Provider Network ...

Project Coordinator

Molina Healthcare - Troy, MI

Job DescriptionJob SummaryProvides 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, ...

Senior Test Analyst

Molina Healthcare - Long Beach, CA

Job DescriptionJob Summary:This role is responsible for validation and investigation of all product quality matters including the development of high level test case scenarios. Primarily manual testing and a lot of documentation using the HP ALM tool.Knowledge/Skills/Abilities:• In-depth knowledge of Testing procedures and theory.• A...

Sr Specialist, Quality Improvement (RN)

Molina Healthcare - Pomona, CA

Job DescriptionJob SummaryMolina'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; an...

Provider Contracts Manager

Molina Healthcare - Troy, MI

Job DescriptionJob SummaryNegotiates agreements with highly visible providers who are strategic to the success of the Plan, including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers.Knowledge/Skills/Abilities• In conjunction with Director/Manager Provider Contracts,...

Sr. Analyst, Data

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryThe Sr. Analyst, Data design and implement 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 ...

Care Review Clinician, Inpatient Review (RN) - Tues-Sat

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...

Care Review Processor Medicaid BH Team

Molina Healthcare - Columbus, OH

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...

Nurse Practitioner, Field (Dona Ana County, NM)

Molina Healthcare - Albuquerque, NM

Job DescriptionJob Summary Care Connections, a division of Molina Healthcare, seeks Nurse Practitioners to join its growing team which will contribute to the company mission to bring quality health care to the underserved. The Care Connections NPs focus on screening, preventive and quality primary care services delivered in the home, community and nursing facility...

Enterprise Director, Healthcare Quality

Molina Healthcare - Troy, MI

Job DescriptionJob SummaryEnterprise Director, Quality is responsible for setting the direction and overseeing Molina's national and/or regional quality operations and activities. Key activities include: serving as the subject matter expert in assigned functional area; leading national and/or regional operations and management of staff; collaborating with national...

Supervisor, Care Management

Molina Healthcare - San Antonio, 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...

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 records.

Rep, Provider Inquiry R&R

Molina Healthcare - Long Beach, CA

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.Provide...