Jobs at Molina Healthcare - Page 4

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Case Manager - Patient Feild Visits - East Metro - Remote.

Molina Healthcare - East St Louis, 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...

AP Expense Processor

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryGeneral accounting tasks for tracking, processing, and payment of invoices for services or goods purchased from vendors. Responsibilities include ensures all disbursements are made under good financial controls while maximizing cash flow opportunities.Knowledge/Skills/Abilities• Generates timely release of payments thro...

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...

Assoc Analyst, Healthcare

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryPerforms research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.Knowledge/Skills/Abilities...

Claims, Provider Inquiry Research and Resolution

Molina Healthcare - Bothell, WA

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.

Senior Applications Developer

Molina Healthcare - Long Beach, CA

Job Description Job Summary Full Stack Web Application Development using Java, Spring Framework, HTML, CSS, JavaScript (Angular.js and Node.js). Designs, develops, and communicates technology models and foundations used to run applications, data, and infrastructure in support of one or more business processes.Applies and promotes key principles ...

Supervisor Utilization Management Registered Nurse

Molina Healthcare - Columbus, OH

Job DescriptionOhio Plan Specific: This role is part of our Utilization Management team. You would be supervising a team of Seasoned Nurses who are responsible for the Prior Authorization and evaluation of medical needs for our members. This role would be great for an experienced Nurse from the Medical Surg background. Job SummaryMolina Healthcare Ser...

Sr Analyst, Healthcare Analytics

Molina Healthcare - Columbus, OH

Job DescriptionOhio Plan Specific: In the Ohio Plan we have organized our team so that this role will have the following Knowledge/Skills/Abilities: Develop ad-hoc reports using SQL Programming, SQL Server Reporting Services (SSRS), Power BI, Medinsight, an dother analytic/programming tools as needed. Analyze data sets and trends for anonmalies, outliers, trend changes ...

Assoc Specialist, Corp Credentialing

Molina Healthcare - North Charleston, SC

Job DescriptionJob SummaryMolina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria in order to minimize liability to the company and to maximize safety for members.Knowledge/Skills/AbilitiesResponsible for coordinating assigned aspects of enter...

Program Manager, HCS (Nurse or Clinical 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 desir...

Mgr, Healthcare Services (RN) Registered Nurse

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...

AVP, Government Contracts

Molina Healthcare - Milwaukee, WI

Job Description Job 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 for the ad...

Transition of Care Coach (RN) Registered Nurse

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...

Member Services Rep

Molina Healthcare - Humacao, Puerto Rico

Knowledge/Skills/Abilities• Respond to incoming calls from members and providers excluding provider claims calls.• Achieve individual performance goals as it relates to call center objectives• Engage and collaborate with other departments as applicable • Comply with workplace safety standards• Comply with regulatory requirements• Demonstrate positive working r...

Actuarial Analyst

Molina Healthcare - Doral, FL

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.