Jobs at Molina Healthcare - Page 5

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Case Manager (RN) Field Nurse: Oakland, Macomb, Genesee Counties

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...

Transition of Care Coach (RN)

Molina Healthcare - Syracuse, NY

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 d...

Case Manager (RN)

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 ...

Case Manager (RN) Springdale Office

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 ...

Supervisor, Appeals & Grievances

Molina Healthcare - Long Beach, CA

Experience in enrollment, premium billing, claims review and member appeal resolution. Ability to identify trends and possible process improvements related to Member Grievances and Appeals and working with various internal departments to implement these changes. Strong writing skills.Responsible for leading, organizing and directing the activities of the Grievance and Ap...

Assoc Specialist, Appeals & Grievances

Molina Healthcare - Long Beach, CA

Molina Healthcare's Appeals & Grievances jobs are 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.Knowledge/Skills/Abilities• Enters denials and requests for appeal into information ...

Analyst, Financial/Pricing

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible for supporting and validating Provider Network contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting. Perform financial modeling to support well-informed negotiations, anticipating issues resulting in the ability to reach contract terms with good fa...

Part- Time Contact Center Associate Rep

Molina Healthcare - Long Beach, CA

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 rela...

Specialist, Government Cntrcts

Molina Healthcare - Long Beach, CA

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• Performs gov...

Specialist, Health Plan Communications

Molina Healthcare - Jackson, MS

Job DescriptionJob SummaryResponsible for the development of communications and marketing activities aimed at brand and message management. Develops, implements, and manages communications programs.Knowledge/Skills/Abilities• With minimal supervision, writes and develops content to support the creation of internal and external commun...

Mgr, Member Engagement

Molina Healthcare - Jackson, MS

Job DescriptionJob SummaryResponsible for continuous quality improvements regarding member engagement and member retention. Represents Member issues in areas involving member impact and engagement including: Appeals and Grievances, Member Problem Research and Resolution, and the development/maintenance of Member Materials. Knowledge/Skills/A...

Bilingual Senior Contact Center Rep

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 rela...

Sr Analyst, Business Systems

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryInterfaces with the customer in developing requirements for major projects of considerable complexity; prepares system design specifications; conducts research to resolve customer initiated issues related to Medicaid claims processing; and coordinates and manages project teams in the development of large multi-system, multi-pl...

Medical Claim Review Nurse

Molina Healthcare - Long Beach, CA

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.Kn...

Auditor, Claims Compliance

Molina Healthcare - Long Beach, CA

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.Kn...