Jobs at Molina Healthcare - Page 5

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VP, Government Contracts

Molina Healthcare - Tallahassee, FL

Job DescriptionJob 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• Oversees the strategic d...

Analyst, Coding (Certified Coder/CPC or CCS)

Molina Healthcare - Syracuse, NY

Job DescriptionJob 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 the Health Care...

Case Manager RN/SW LTSS Nursing Facility Cincinnati

Molina Healthcare - Cincinnati, 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...

Correspondence Processor

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...

Specialist, Community Engagement (FIELD MARKETING REP-Cortland/Tompkins Counties)

Molina Healthcare - Cortland, NY

Job DescriptionJob SummaryResponsible for achieving established goals improving Molina's enrollment growth objectives encompassing all lines of business. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages.Knowledge/Skills/Abilities• Under limited supervision, responsible fo...

Associate Rep, Provider Inquiry

Molina Healthcare - Irving, TX

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...

Clerk, Mailroom

Molina Healthcare - Bothell, WA

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, ...

Auditor, Medicare Quality

Molina Healthcare - Long Beach, CA

Knowledge/Skills/Abilities• Track, report and trend quality outcomes. Present quality program results to executive leadership team.• Develop, implement and manage Medicare sales call calibration exercises.• Develop and manage policies and procedures for Medicare sales call quality program.• Performs Medicare sales call monitoring and assessment of licensed and non-lic...

Supv, Claims

Molina Healthcare - San Juan, Puerto Rico

Job DescriptionJob SummaryResponsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. 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/Skil...

Lead, Core Ops

Molina Healthcare - San Juan, Puerto Rico

Job DescriptionJob SummaryResponsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. 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/Skil...

Sr Examiner, Claims

Molina Healthcare - San Juan, Puerto Rico

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• Meets and consistently maintains production standards for Claims Ad...

Sr Examiner, Claims

Molina Healthcare - San Juan, Puerto Rico

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• Meets and consistently maintains production standards for Claims Ad...

Examiner, Claims

Molina Healthcare - San Juan, Puerto Rico

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 principles and ...

Examiner, Claims

Molina Healthcare - San Juan, Puerto Rico

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 principles and ...

Examiner, Claims

Molina Healthcare - San Juan, Puerto Rico

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 principles and ...