Jobs at Molina Healthcare - Page 5

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Sr Analyst, Business

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryAnalyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creat...

Associate Analyst, Business

Molina Healthcare - Irving, TX

Job DescriptionJob SummaryAnalyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creat...

Care Review Clinician, Inpatient Review (RN)

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 ...

Supervisor, Care Management

Molina Healthcare - El Paso, 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 ...

RN Analyst

Molina Healthcare - Baton Rouge, LA

Job DescriptionJob SummaryReviews claims utilizing records and system reports to determine proper documentation, utilization and appropriateness of services to identify possible fraud and abuse.Knowledge/Skills/Abilities• Performs post payment analysis of medical claims and records.• Uses independent judgment to determine sanctio...

Medical Director, Health Plan

Molina Healthcare - Midvale, UT

Job SummaryServes as the UM leader & primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the provision of medical staff services. Maintains a working knowledge of applicable national, state and local laws and regulatory requirements affecting the medical and allied ...

Registered Nurse Transition of Care

Molina Healthcare - Syracuse, NY

Job DescriptionNew York Plan Specific: On Site Registered Nurse Transition of Care RN-NY DAY IN THE LIFE:We are so excited about this role. Molina Healthcare has long provided quality healthcare services to over 4.5 Million people nationwide. We are somewhat new to the New York market...

Financial Analyst, Healthcare Analytics

Molina Healthcare - Columbus, OH

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/Abili...

Sr Analyst, Finance

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryResponsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and similar financial projects or programs. Duties include gathering, interpreting, and evaluating financial information; generating forecas...

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 unstruct...

Supervisor, Member Services

Molina Healthcare - Irving, TX

Job DescriptionJob SummaryProvides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and service information to members, and identifies opportunities to maintain and increase member rel...

National Benefit Advisor

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryTelesales role. Responsible for taking and making telephone calls with prospective members with the intent to educate them on benefits of Molina products and then conducts enrollment into product of choice over the phone or other sales enrollment channel desired.Knowledge/Skills/Abilities• Strong working kno...

Assoc Rep, Provider Services

Molina Healthcare - Irving, TX

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...

Manager, Provider Services

Molina Healthcare - Irving, TX

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...

RN Case Manager - Telephonic

Molina Healthcare - Midvale, UT

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 ...